Background: Surgery is the only treatment for symptomatic saccrococcygeal pilonidal sinus. Various surgical techniques are described in literature; yet, the ideal technique is still controversial because of the high recurrence rate that is associated with the majority of the techniques.   Aimof the work: To  evaluate  Limberg  flap  closure  for  the  treatment  of  primary  pilonidal  sinus  by  comparing  its operative and postoperative outcome with open excision and healing by secondary intention.   Methods: This is a prospective randomized trial which enrolled eighty patients with primary pilonidal sinus from May 2015 to April 2018. The patients were divided into two groups. Group A included forty patients who underwent excision  and the wound was left to heal by secondary intention. Group B included forty patients who underwent rhomboid excision and Limberg flap repair.   Results: The operative time was significantly longer in group B. Duration for complete wound healing and return to work were significantly longer in group A. There was no statistically significant difference between both groups neither in recurrence nor in postoperative complications.   Conclusion: Although recurrence was the same with in healing by secondary intention and Limberg flap, yet rhomboid excision and Limberg flap closure for the management of primary pilonidal sinus is better option in terms of wound healing and early return to work.