Pilonidal disease is a common surgical problem primarily affecting young men between puberty and early thirties and is estimated to affect 26 per 100 000 individuals. surgery is still the primary method of treatment of the disease. Surgical management is usually simple, inexpensive, and is associated with a short hospital stay and rapid wound recovery. The aim of this study was to describe the effect of 5 layers repair technique in the management of pilonidal sinus as regard postoperative efficacy and results regarding pain,wound healing and recurrence. the study included 20 patients with a history of discharge from sacrococcygeal region that is clinically diagnosed as pilonidal sinus. Patients were treated by excision of the whole track till the pre sacral fascia and periosteum (Five Layers Repair) There mean age of patients was 31 years and 18 patients were males, 3 patients presented with discharge only , 6 of them with pain and 11 patient presented with both pain and discharge. Mean time to wound healing was 12 (±2), while Mean time to removal of stitches was 14( ±1) and 21 days was to return to work (±1), 19 patient came with complete healing and only 1 patient showed wound beakdown. Reccurence didn't happened to any patient after 6 month of surgery. Our findings indicated that 5 layers repair technique was superior to other techniques in terms of less operative time, less post-operative VAS of pain, no rate of recurrence presented with patients in our study.