OBJECTIVES: To investigate the clinical efficacy of keloid core excision combined with triamcinolone acetonide (TA) local injection for the treatment of auricular keloids. METHODS: From May 2019 to November 2021, 86 patients with auricular keloid who met the inclusion criteria were enrolled. Based on treatment modality, they were divided into two groups: a research group (n=43) receiving keloid core excision combined with TA local injection and a control group (n=43) undergoing keloid core excision alone. The clinical efficacy, postoperative adverse reactions, Vancouver Scar Scale (VSS) score 12-Item Pruritus Severity Scale (12-PSS) score, sleep quality, serological indicators, Self-Rating Anxiety Scale (SAS) score, Self-Rating Depression Scale (SDS) score, Short-Form 36-Item Health Survey (SF-36) scores, recurrence rate, and treatment satisfaction were compared between the two groups. RESULTS: The research group showed superior overall clinical efficacy, higher SF-36 scores, fewer total adverse reactions, and better sleep quality compared to the control group. Additionally, the research group had lower VSS, 12-PSS, SAS, and SDS scores, more significant reductions in serological indicators, and a reduced recurrence rate. CONCLUSIONS: Keloid core excision combined with TA local injection was more effective than keloid core excision alone in treating auricular keloids, with significantly better clinical efficacy.