Abstract—Pilonidal abscess and sinus in sacrococcygeal area are a common occurrence in youth. Various surgical and non-surgical modalities are used for managing this condition. There is high chances of recurrence with all modalities of treatment. Various complications do arise even after surgery. This case series presents clinical outcome of one surgical procedure-rhomboid excision with modified Limberg flap, practiced at our hospital. In our hospital 35 patients with newly diagnosed pilonidal sinus and recurrent pilonidal sinuses were treated with rhomboid excision and modified Limberg flap during a period of two year, i.e., from June 2009 to May 2011. These patients were followed up post-operatively for a mean duration of 1 year. This surgical technique showed promising results with regards to less post-operative complications, short hospital stay and low recurrence rate. Out of 35 patients, only 7 cases presented with various complications. One person had recurrence, two had seroma formation and four had wound infection.