Objective: To determine outcome of reconstruction of pilonidal sinus with different treatment modalities following excision at Liaquat University Hospital. Methods: A prospective descriptive study conducted from March 2006 to February 2010 at Department of Surgery & Department of Plastic Surgery, Liaquat University of Medical & Health Sciences, Jamshoro. A total of 22 male patients with primary pilonidal sinus were admitted in Department of Surgery and Department of Plastic & Reconstructive Surgery, LUMHS Jamshoro were included in the study. Results: All patients were male with median age of 25 years. Majority of patients i.e. 14 (63.63%) were between age 20-29 years. Primary closure was performed in 3 cases (13.63%); double opposing rhomboid flap was performed in only one case (4.54%). Local advancement flap was performed in 4 cases (18.18%). Rhomboid flap was done in majority of cases i.e. 12 cases (54.54%). Bi-lobed flap was done in 2 cases (9.09%) only. No flap necrosis was observed. Wound infection was found in 3 cases (13.63%). Seroma was observed in one patient (4.54%). Hematoma formation was observed in 2 cases (9.09%). Recurrence of pilonidal sinus was observed in 3 cases (13.63%). Conclusion: Lesions heal faster with primary closure than with open healing in pilonidal surgery but risk of recurrence is increased. Rhomboid flap & double opposing rhomboid flap were found to be a good choice for moderate sized wounds.