Purpose: Small-medium sized keloid scars are a common presentation to the Plastic Surgery clinic at Royal Darwin Hospital due to the high proportion of patients of Aboriginal, Torres Strait Islander and Asian ethnicity. Keloids are bothersome, causing pain, itch, unpleasant appearance, and can impair function and quality of life. Small-medium sized keloids are often treated with intralesional injection of a corticosteroid or 5-fluorouracil (5-FU) as an adjunct to simple scar management techniques. It remains unclear if intralesional injections of corticosteroid and 5-FU in combination is superior to corticosteroid alone. Method: A systematic review was undertaken to investigate whether intralesional injection of corticosteroid plus 5-FU was superior to intralesional injection of corticosteroid alone. Results: 9 trials were identified that met the study criteria. Overall, the studies reported that combination therapy of corticosteroid plus 5-FU yielded significantly better outcomes on Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS), and fewer adverse events and lower rates of recurrence when compared to corticosteroid monotherapy. None of the studies however were based in Australia. Conclusion: There is evidence that for small-medium sized keloid scars, intralesional injection of corticosteroid and 5-FU in combination is superior to corticosteroid alone. The authors propose a randomised control trial to investigate if this benefit is also observed in a population of Aboriginal and Torres Strait Islander people.