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A Pilonidal sinus (PNS) occurs in the cleavage between the buttocks (natal cleft) and can cause discomfort, embarrassment and absence from work. The incidence of the disease is calculated to be 26 per 100,000 people. It occurs 2.2 times more often in men than in women. It is more common in men (as they have more hair). The most commonly used surgical techniques for this disorder include excision and primary closure and excision with reconstructive flap. However, the risk of recurrence or of developing an infection of the wound after the operation is high. Also the patient requires longer hospitalization, and the procedure is expensive. There is a similarity between ShalyajaNadiVrana described in Sushruta Samhita and Pilonidal sinus. Sushrutahas advocated a minimally invasive para-surgical treatment, KsharaSuthraprocedure for NadiVrana. Hence this therapy was tried in Pilonidal sinus, and is described in this case report. KsharaSutra treatment not only minimizes complication and recurrence but also enables the patients to resume work quicker and with less discomfort, impact upon body image and self- esteem as well as reduce cost.