Aspirin has usually been taken for pain relief originating in the nidus of osteoid osteoma, however it takes too long to become effective. Because of the protracted painful course and the unpredictability of regression, osteoid osteoma is usually removed. And then, the defective host bone is internally fixed by plate and screws and augumented by autogenous bone graft. However, the common intracortical location and exuberant periosteal reaction hinders the exact intraoperative localization of the nidus. The authors managed 6 patients by computerized tomography-guided percutaneous nidus excision with a relatively small skin incision, small cortical window, short operation time and no bone graft. It may be one of the best options for removal of the nidus of osteoid osteoma with certainty.