Abstract Background: Different techniques, including conservative therapy and a fasciocutaneous rotation flap, are utilized to treat pilonidal sinus illness. This study's objective was to assess the effectiveness of "de-epithelialization technique" as a novel method for managing pilonidal sinus condition. Aim of Study: The present work aimed to describe the condition and the "de- epithelialization procedure" as a novel strategy for managing Pilonidal sinus disease. Patients and Methods: Forty patients with pilonidal sinus illness who had de-epithelialization therapy were assessed. Age, gender, BMI, number of operations, length of hospital stays, visual analog scale scores, complications, and recurrent rates for each patient were assessed. Results: In this research, there were 37 male patients and 3 female patients. The patients' average age was 26.52 years, and their average BMI was 24.58. The average procedure lasted 63.23 minutes, and the majority of patients were released the same day. Healing times for wounds ranged from 9 to 14 days. Two individuals with high body mass indices had wound dehiscence and infection. Post-operative hematoma was found in only one patient. Throughout the follow-up period, no patient had seromas or a recurrence. Conclusion: With satisfactory cosmetic results and recur-rence rates, "de-epithelialization" may be used in conjunction with other therapies for pilonidal sinus illness.