Background: There is no universally accepted treatment resulting in permanent hypertrophic or keloid scar ablation. Multiple modalities of treatment have been advocated. Most of these modalities have a variable and transient success. Hence there is need for evaluation of better modalities to achieve good cosmetic acceptability. Aim: To study the efficacy and safety of intralesional triamcinolone, topical silicone gel sheet and intralesional triamcinolone plus topical silicone gel sheet in treatment of keloid or hypertrophic scar. Methods: Total 150 patients with keloid or hypertrophic scar, randomly divided into three groups (50 each), treated with intralesional triamcinolone (Group A), topical silicone gel sheet (Group B) and intralesional triamcinolone plus topical silicone gel sheet (Group C) for a maximum period of 6 month. The groups were compared for reduction in size and the side effects. Ultrasonography of the lesions using 10- 12 MHz Linear transducer was done to assess the baseline dimension before starting the treatment & at the end of the study period. Clinical improvement was assessed by photography & measurement scale serially till the scar flattened at each visit. Results: The overall therapeutic response in terms of size reduction in group C was found to be better and statistically significant (p value < 0. 01) compare d to group A & B. Conclusion: Combination therapy was more effective with faster results and few side effects.