This prospective study was designed to compare the three surgical procedures used in the treatment of pilonidal sinus. 103 patients divided in to three groups by simple random sampling, Group I, 45 patients treated by Excision alone, Group II, 45 patients treated by Excision and simple primary closure while group III, 13 patients treated by Excision and w plasty. Comparison between these procedures with regard to Gender, Sex, Obesity, operating time, hospital stay and complication include recurrence by using ANOVA test and other statistical tests. In conclusion, there is relation between obesity and PND and its Recurrence, also excision alone is satisfactory procedure, because it take less operative time with short hospital stay and associated with fewer complication including recurrence, also meticulous hygiene and shaving of present healing area as well as daily regime to obese patient should be taken in consideration to avoid recurrence.