Background Median stemotomy remains the preferred technique in open heart surgery.The middle part of the chest is a predilection site for keloids.Keloids are often accompanied by itching and pain,and seriously affect the beauty and quality of life.The main treatments of keloids include surgical resection,local injection of drugs,laser,cryotherapy,compression therapy,and topical application of silica gel.Unfortunately,there is no way to achieve superior results.Therefore,there is a need to find an effective way to treat keloid after median steoto my.Our study was designed to investigate the effect of reducing the tension of the skin and the early electronic line irradiation on the treatment of keloid after median steotomy.Methods A retrospective analysis was performed in 54 patients with keloid after median steotomy treated by reducing the tension of the skin and removing the keloid,followed with electron beam irradiation treatment 24 hours after the operation.For each patient,5 Gy electron beam irradiation was used every day after the operation for 4 days with the total dose of 20 Gy.The patients were followed up at 6 months and 12 months after surgery.Results Fifty-four cases of patients were followed up for at least 6 months.In 6 months follow-up,there were significant effects in 34 cases with a total effective rate of 98.1％.In 12 months follow-up,33 cases were cured with the total effective rate was 96.3％.Conclusion The treatment of keloid after median steotomy can be achieved by the combination of tension reduction surgery and early electronic line irradiation.