Hypothesis: we state that our personal method constitued by exicission and prymary clausure in the treatment of pilonidal sinus, is able to obtain a low rate of recurrence and a fast return to work. Patients and methods: our report has been conducted on 315 patients. Exicission and prymary clausure in the treatment of pilonidal sinus by loco-regional anesthesia. The patients have been discharged on second day. Results: we have not had intraoperative complication; abaut morbilità there have been 4% of seromas treated conservatively. Conclusions: whith this personal method we have obtaned very good results, in short and long time, with less of recurrences and fast return to work.