Abstract: Objective To investigate the effects of superficial circumflex iliac artery perforator flap combined with postoperative radionuclide radiotherapy on perineal keloid. Methods A total of 65 patients with perineal keloids were divided into study group and control group according to their treatments, which were treated with superficial circumflex iliac artery perforator flap and combination of superficial circumflex iliac artery perforator flap and radionuclide radiotherapy. Then, both groups were compared for clinical efficacy, scar hyperplasia, and keloid recurrence. Results Companed with the control group, the study group presented remarkably improved efficacy and marked relieved postoperative scar hyperplasia, and significantly reduced incidences of keloid recurrence within 1 year after surgery (P<0.05). Conclusions The superficial circumflex iliac artery perforator flap combined with postoperative radionuclide radiotherapy not only present good effects on perineal keloid, but can also inhibit postoperative scar hyperplasia and reduce postoperative keloid recurrence, which is worthy of clinical promotion and application.