To evaluate the technical feasibility and efficacy of percutaneous cryoablation for the treatment of osteoid osteoma (OO) in adults. 21 patients (12 male and nine female; mean age, 29.9 years) who underwent CT-guided percutaneous cryoablation for the treatment of OO were retrospectively evaluated. Procedures were carried out under local anaesthesia and conscious sedation in 13 patients, and under general anaesthesia in eight patients. Then, the ablation zone was evaluated with post-procedure magnetic resonance imaging at 6 weeks. Clinical outcome was assessed using a visual analogue scale (VAS) to evaluate severity of pain before procedure, as well as at primary (6 weeks) and secondary follow-up (6-40 months). All procedures were technically successful. Median VAS scores were: 8 (range, 5-10) before procedure and after procedure, respectively, 0 (range, 0-2; p < .0001) and 0 (range, 0-7; p < .0001) at primary and secondary follow-up. There were three minor complications (14.3%) and no major complication. A single patient reported symptom recurrence (4.8%) at secondary follow-up and successfully underwent a second cryoablation procedure. CT-guided percutaneous cryoablation is safe and effective in the treatment of OO in adults, and can be accomplished without general anaesthesia in selected cases. aEuro cent CT-guided percutaneous cryoablation of osteoid osteoma is safe and effective aEuro cent Cryoablation allows precise visual control of the aggregated iceball during procedure aEuro cent Percutaneous cryoablation can be accomplished without general anaesthesia in selected cases aEuro cent Another advantage of cryoablation is reduction of immediate postprocedural pain aEuro cent Post-procedure MRI is helpful in the evaluation of technical success.