Pilonidal disease is a chronic infection of the skin in the region of the buttock crease. The condition results from a reaction to hairs embedded in the skin, commonly occurring in the cleft between the buttocks. The disease is more common in men than women and frequently occurs between puberty and age 40. It is also common in obese people and those with thick, stiff body hair. Pilonidal disease is a disease of young people, usually men, which can result in an abscess, draining sinus tracts, and moderate debility for some. This is a condition dealt with by general practitioners, accident and emergency departments, general surgeons, colorectal surgeons, plastic surgeons, district nurses and wound-care specialists. It is an unglamorous condition that, despite its prevalence, seldom achieves priority within a busy clinical practice. However, its complex debilitating nature and negative economic effects for the predominantly affecting the young working population should not be underestimated.