Percutaneous radiofrequency treatment of osteoid osteoma has been performed for more than 10 years. It is the preferred method of treatment for most patients in those centers that offer it, and has been shown to be a safe, effective, and cost-effective alternative to operative treatment (1–5). However, many patients continue to be subjected to the increased risks and lengthy recovery of open surgery or to the prolonged discomfort and risks associated with medical therapy. This is presumably because of lack of awareness of the technique or benefits of percutaneous treatment. This chapter provides a detailed description of proper patient selection, technique, and follow-up for those wishing to perform this therapy.