Background: The Keloid is an elevated fibrous scar that may extend beyond the borders of the original wound. Object: To compare between topical and intralesional mitomycin C in the treatment of auricular keloids. Patients and methods: Prospective randomized study in which 40 patients with auricular keloids were included. The patients were divided into 2 groups, Group I included 32 patients who underwent topical mitomycin C application after the surgical removal of the auricular keloids, while Group II included 8 cases who underwent intra-lesional injection of mitomycin C after surgical removal of the auricular keloids. Results: The two groups showed no significant difference regarding patient or lesion criteria (p > .05). VSS decreased significantly from 10.63 and 11.0 down to 1.38 and 3.0 after treatment in the topical and intra-lesional groups respectively (p < .001). However, greater improvement and satisfaction was detected in the topical group. Conclusion: Both topical and intra-lesional mitomycin C injection are effective methods in managing auricular keloids. However, better VSS scores and patient satisfaction are reported with topical administration