Pilonidal sinus is a very common problem that often arises in the natal cleft of between the buttocks. The main reason of pilonidal sinus is due to penetration of hair through the skin into subcutaneous tissue. It forms unhealthy granulation tissue and helps the infection to grow. It is common in males than females as they have more hairs on body. More commonly seen in between age group of 20-40 years. Achraya Susruta described different types of Nadi Vrana. Among them Salayaj Nadi Vrana can be corelataed with Pilonidal Sinus. Accordind to Achraya Susruta treatment of Nadi Vrana is Chedana Karma or with the usage of Kshara Sutra. A pilonidal Sinus can be completely managed in Ayurveda by Chedana Karma and Kshara Sutra.