Background: Published results have shown that fibrin glue may be effective in closure of pilonidal fistula. We report the final results of a randomized clinical trial evaluating the use of fibrin glue in treatment of pilonidal fistula. Objectives: to determine the efficacy of a new simple with minimal tissue loss and a low recurrence rate technique that uses fibrin glue in the closure of pilonidal sinus (PS) in comparison with surgical technique. Methods: the results of treatment of pilonidal fistula by fibrin glue in 10 patients were compared with those obtained by conventional surgery in another 30 patients, we carried out this study on 40 patients at Al-Zharaa University Hospital, Egypt between March 2017 and March 2019. The outcome was evaluated by recurrence or not. Results: out of 40 patients, 19 patients were male and 21 were female. Fibrin glue injection was done in 25% of patients and surgery was done in 75%. Recurrence occur in 10 % in fibrin glue and 36 % by surgical treatment. Conclusion: fibrin glue is a simple, reasonable, feasible, reproducible technique and competitive alternative to other surgical intervention. It is accompanied by a reduction in pain, reducing hospital stay, minimizing tissue assault, promoting early work resumption and with lower recurrence rate. Inspite of the surgical approach is still the standard modality for pilonidal sinus treatment.