Despite the numerous publications during the last eight decades, considerable discrepancies in the treatment of patients with the sacrococcygeal pilonidal disease still exist. A cohort study aimed to explore our experience in the management of this entity. The study included 24 patients with the chronic pilonidal disease, 18 males and 6 females, with the male to female ratio of 4:1. Their mean age was 22.96 ± 4.329 years. Multiple openings were seen in 79.2%. Surgical technique was Limberg flap, simple primary closure, and open approach, healing by secondary intention applied in 58.3%, 25%, and 16.7% respectively. Patients were discharged from hospital when became fully mobilized, pain controlled and drain had been removed. The mean hospital stay was 2.4 days. The overall recurrence rate with follow up of 1 year was 4.2%. Adopting a simplified criterion for handling sacrococcygeal sinus depends on sinus extension and the number of openings will result in a good outcome.