Keloid disease presents a healthcare challenge: patients suffer from pruritus, pain, inflammation, and cosmetic disfigurement. There is no single effective therapeutic regimen for keloids. Numerous treatment options have been described including occlusive dressings, compression therapy, intralesional steroid injections, laser and radiation therapy, cryosurgery, 5-fluorouracil, interferon, and imiquimod cream, but managing keloid disease still is a considerable problem for clinicians. Better understanding of the molecular mechanisms behind keloid disease led to the development of new promising therapies like the application of recombinant TGF-b3, interleukin 10, and imatinib mesylate. This review provides an overview of the existing therapeutic options for keloid disease and summarizes upcoming future therapies with a special focus on blocking the transforming growth factor-beta pathway.