To evaluate the efficiency and complication rate of two percutaneous treatments of osteoid osteomas, percutaneous trephine resection (PR) and interstitial laser ablation (ILA). Ethical review board was obtained for the retrospective study. One hundred and 26 patients were treated by PR (n = 26) or ILA (n = 100) under CT, with a median follow-up of 113 months for the PR group and 47 months for the ILA group. In the group treated by PR, the clinical success rate was 96% at 6-month and 95% at 24-month follow-up, with 12% (3/26) transient complications (one meralgia, two skin burns). One patient experienced immediate failure, and none had delayed failure. In the group treated by ILA, the clinical success rate was 96% at 6-month and 94% at 24-month follow-up, with 4% (4/100) transient complications (one common fibular nerve contusion, one hematoma, one infection and one tendinitis). Four ILA procedures were repeated, one because of initial failure and three because of recurrence (at 6.5, 15 and 32 months). Two were successful and two failed again. Failure was more frequent (p = 0.0094) in patients less than 18 years old, and in lesions with a nidus size of 12 mm or larger (p = 0.0022).