A procedure for outpatient excision and closure of pilonidal cysts and sinuses under local anesthesia is described. The operation is designed to reduce hospital expenses and loss of work time. It utilizes the low tissue friction properties of polypropylene sutures to effect full dead space obliteration and a home care regimen to minimize the incisional tension produced by sitting. Of thirty-two procedures performed, follow-up data were available for twenty-eight, with a mean postoperative time of twenty-four months. Full primary healing was obtained in all cases with a single early wound disruption. There have been no late recurrences.