Pilonidal sinus (PNS) is a chronic disorder that occurs in the space between the buttocks (natal cleft). Men are more susceptible (because they have more hairs) to pilonidal sinus than women. Excision,primary closure and reconstructive surgery are most commonly used surgical technique for this disease.However, there is high risk of recurrence or wound infection after surgery.In addition , the patient needs longer hospitalization and the procedure is expensive.There is similarity between shalyaja nadi vrana described in Sushruta Samhita and Pilonidal sinus.Sushruta has advocated a minimally invasive para-surgical treatment i.e. ksharasutra procedure is not only minimizes complications and recurrence but also enables the patients to resume work quicker and with less discomfort,impact upon body image and selfesteem, as well as reduce cost.