Purpose: The management of symptomatic pilonidal disease is variable, with multiple surgical techniques described in the literature. Extensive disease is often managed by excising all sinus tracts, followed by either primary or delayed wound closure. For limited disease there have been recent advancements in surgical techniques, including minimally invasive resection such as with endoscopic techniques. The purpose of this study is to compare success rates of open excision and endoscopic management, and to ascertain if endoscopically managed cases heal faster. Methodology: Patients’ records will be accessed by members of the research team to identify patient outcomes following diagnosis of pilonidal sinus disease from 2018-2023. Operation notes will be reviewed to determine date of operation, and type of operation – open vs endoscopic, acute vs elective. Clinic notes will be reviewed to determine whether the wound has healed. Results: After exclusions 29 elective operations remained, of which 12 were open debridements, and 17 were endoscopic. Evidence of successful healing was documented in 90% of patients undergoing open debridement, with a median time to healing of 119 days. 85% of those having endoscopic debridement had healed, with a median time to heal of 48 days. Conclusion: This study shows excellent healing rates amongst patients managed with both open and endoscopic techniques. Patients having endoscopic debridement tended to heal faster than those having open debridement. This could lead to lower costs as well as increased patient satisfaction.