Background: De-epithelialization is a surgical procedure that has been used effectively in mammaplasty by plastic and reconstructive surgeons since the 1970s. This method has been utilised in a variety of specialty fields for a variety of uncommon indications.
Aim of the Work: To compare between de epithelization technique and rhomboid flap in management of pilonidal sinus.
Patients and Methods: This comparative study was conducted at Department of General Surgery in Al azhar university hospitals.  This study carried out on 30 consecutive patients with sacrococcygeal pilonidal sinus.
Results: The included 30 patients (15 patients in each group) the mean age of de epithelization technique was 21.67 ± 6.03 and 25.13 ± 8.73 for the rhomboid flap technique, with no significant difference (p-value > 0.05) between both groups in age, gender or BMI.
Conclusion: In compared to the Rhomboid flap approach, the De-epithelization technique had a much shorter operating time, a significantly better functional result, and a significantly shorter inpatient duration.