Background: Pilonidal disease is persistent sacrococcygeal inflammation and infection. Theories include congenital and acquired causes. Karydakis and Limberg flaps can treat pilonidal sinus. The conventional method replaces the vulnerable raphe with healthy tissue. The Karydakis flap was modified by suturing its base to the wound's lateral border. Limberg flap involves excision of rhomboid area down to presacral fascia and transposition of fasciocutaneous flap medially to cover defect without strain. The flap matched the rhomboid area. Aim: to compare the karydakis technique and the limberg flap approach for surgically treating pilonidal sinus disease in terms of wound healing, wound complications, recurrence rate, length of operation, and time to return to work. Subject and Methods: 50 patients with sacrococcygeal pilonidal sinus illness participated in this prospective trial, which was divided randomly into two groups.Results: In the Limberg Flap group, hospital stays were much shorter. After surgery, there was a highly significant reduction in pain and healing in the Limberg Flap group. Between the two groups, there was no discernible difference in the time it took for complete healing.In the Limberg Flap group, satisfaction was noticeably higher. Regarding affected location, there was no discernible difference between the two groups among the included individuals. Conclusion: Pilonidal disease patients typically receive therapy with Limberg flap surgery.In comparison to Karydakis flap surgery, it is less problematic, quicker to return to work, more patient-satisfied overall, and heals wounds more quickly.