Introduction: Pilonidal disease is now considered an acquired dermatologic disease. Numerous surgical and non-surgical techniques have been suggested for the treatment of pilonidal sinus. It usually requires a radical surgical procedure with a long stay in hospital, discomfort and loss of earning. The purpose of this study was to observe the outcome of surgical and non-surgical management of pilonidal disease. Material and methods: The present prospective observational study was carried out from November 2014 to October 2016 in Tertiary Care Hospital. It describes the clinical profile and outcome of sacrococcygeal pilonidal sinus managed by surgical methods and nonsurgical method. The study included a total of 46 patients out of which 24 underwent surgical management and 22 underwent management by non-surgical technique. Results: The majority of patients in both groups were in the age group 15 to 35 years. Students were more affected with Pilonidal disease in both groups. (54.54% & 50 %respectively). Discharge followed by pain was the most common presenting complaint seen in both the groups. 54.54 % (12) cure rate was seen with single sitting whereas27.27% (06) with two sittings and 18.18% (04) with three sittings. Wound dehiscence was seen as early complication in surgical group whereas skin ulceration was seen one case in non-surgical group. Conclusion: To conclude, non-surgical management of pilonidal sinus (Crystallized phenol injection) is an effective, feasible, low cost, simple, minimally invasive outpatient procedure with early recovery and return to work, better cosmetic outcome, less perioperative pain and gives acceptable results.