Background: Desmoid tumours are an important cause of mortality in familial adenomatous polyposis (FAP). There are few effective treatment strategies. This report describes the use of radiofrequency ablation to debulk and palliate an abdominal wall desmoid tumour in FAP. Methods: A 22 year old woman with FAP developed a large abdominal wall desmoid tumour after restorative proctocolectomy. The tumour was treated with 16 separate radiofrequency ablations. The follow up was 36 months from the first ablation. Results: The procedure was well tolerated with minor complications; mild superficial cellulitis and skin ulceration occurred following only one of the ablation sessions. Repeated radiofrequency treatments resulted in a sustained reduction in size and symptoms from the desmoid tumour. Conclusion: Given the low efficacy of treatments for desmoids in FAP, radiofrequency ablation appears to be a promising modality. © 2012 The Association of Coloproctology of Great Britain and Ireland.