A series of forty-three keratoacanthomas were treated with Mohs' micrographic surgery with the use of the fresh-tissue technic. Of forty-two keratoacanthomas followed from 6 to 24 months, one aggressive keratoacanthoma recurred, yielding an overall recurrence rate of 2.4%. Micrographic surgery is an expedient treatment that allows for complete microscopic examination of the keratoacanthoma, maximum preservation of normal tissue, and a high degree of assurance of cure.