Sacrococcygeal pilonidal sinus disease is a disease at the natal cleft with a prevalence of 8.3%. The optimal treatment of primary pilonidal sinus disease is a widely discussed topic with many different surgical treatment options available. Currently, a golden standard for the best available treatment of pilonidal sinus disease is lacking. However, radical excision of primary pilonidal sinus disease with off-midline wound closure or secondary wound healing is the mostly applied treatment modality nowadays. A high rate of surgical site infections and chronic open wounds has been reported after radical excision, resulting in a prolonged disease burden and subsequent socio-economic damage. Therefore, less invasive treatment options for primary pilonidal sinus disease, including laser, endoscopic ablation of the sinus tract and sinus pit excision combined with debridement and phenolisation of the sinus tracts are becoming increasingly popular. After the latter technique, smaller surgical wound(s), less pain and discomfort, shorter wound healing times and less days unable to do daily activities have been reported compared to radical excision, with a comparable recurrence rate in the long run. In addition, the phenolisation technique does not seem to have a negative impact upon outcome in case radical excision is required because of recurrence after phenolisation. Therefore, the phenolisation technique can be considered as primary treatment option in patients with primary pilonidal sinus disease. In the current video, the technical details on sinus pit excision combined with debridement and phenolisation of the sinus tracts in a patient with sacrococcygeal pilonidal sinus disease will be shown.