The treatment of pilonidal disease (PD) is extremely important now. Its incidence is up to 5% of the adults. PDtakes the fourth place among such coloproctological diseases as hemorrhoids, abscess and fistula-in-ano and anal fissure. The first experience of PD was described two centuries ago. During this period, various theories on etiology and pathogenesis of the disease were suggested. The western papers support the idea that the acquired genesis is a cause of PD. This point of view is the

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... site to the countries of the former USSR, where pilonidal disease is considered as congenital pathology. Numerous procedures have been proposed because of the different theories of the etiopathogenesis if you take the point of view that the PD is a congenital disease it should be mentioned that the main goal of these methodsiselimination of pilonidal cyst with closure of the wound or without. If to consider PD as an acquired disease, the surgical break of pathogenetic mechanism is a key. Thisapproach includes: Bascom I, Cleft Lift, EPSiT procedures. Every procedure for PD has certain indications and contraindications. The aim of the review is to compare the main methods and determine their strengths and weaknesses. Unfortunately, today there is no "gold standard" in the treatment of pilonidal disease.