Abstract The paper reports our experience in the treatment of keratocysts and make recommendations for treatment in the form of a retrospective study. Thirty-eight patients with 52 keratocysts out of a total of 318 patients with 351 odontogenic cysts who presented between 1984 and 1992 were analysed. Outcome was measured by recurrence and there were three recurrences (6%) which compares favourably with published reports in which figures of up to 62% have been quoted. Based on the experience of others as well as our own series we recommend that small cysts near the alveolar process should be treated by simple excision, but large invasive cysts near the base of the skull should be treated by radical resection leaving a margin of normal tissue around the specimen. If any variables are discovered that can reliably indicate prognosis we may be able to revise these recommendations.