A pilonidal sinus (PNS), which can result in discomfort, humiliation, and missed work, is in the cleavage between the buttocks (natal cleft). Men are more likely than women to have it because they have more hair. For this disorder, the most often utilized surgical techniques are excision combined with primary closure and excision combined with reconstructive flap. Nonetheless, there is a significant chance of infection or recurrence following surgery. In addition, the procedure is costly and the patient needs a longer stay in the hospital. Pilonidal sinus and Nadi Vrana, as described in Sushruta Samhita, are similar. For nadi vrana, Sushruta has recommended the minimally invasive Kshara Sutra procedure as a para-surgical treatment. The patient attended Shalya Tantra OPD of SDM College of Ayurveda & Hospital was treated with the Apamarga Kshara Sutra. The patient recovered well with complete excision of the tract.