One hundred and two patients with a pilonidal sinus treated by minor excision had a life-table of 5-year freedom from recurrence of 89% provided that they attended a dressing clinic until the wound healed. With failure to attend the clinic, the recurrence freedom fell to 57% (P less than 0.004). Age, sex, acute abscess, previous excision, presence of hairs and the number of midline pits and lateral abscesses did not significantly influence the result. The method supersedes more extensive procedures, but should be tested against even less traumatic techniques.