disease. The exact etiology of the disease is still unknownbut the most accepted theory is an acquired condition characterizedby infected sinus in the natal cleft area contains lifelesshair tuft. Multiple techniques were prescribed for its treatmenthowever the ideal method still not yet defined.Patients and Methods: Fifty eight male patients whounderwent excision of their recurrent pilonidal sinus diseaseand the resulting defects were reconstructed using combinedhorizontal split gluteus maximus flaps and rhomboid flaps.Outcomes were revised from patient's files case and followedup in outpatient clinic and via questionnaires.Results: The mean hospital stay was three days. The meantime to return to work was 16 days. Partial wound dehiscence'soccurred in two patients. Distal end flap necrosis occurred inone patient. There were no flap losses, no recurrences, noinfections, no loss of function and no seromas during a meanfollow-up period of 24 months. All patients were satisfiedwith the results.Conclusion: In comparison with other techniques, it hasa comparable operative time and hospital stays. It has minimaland acceptable complication rates and no recurrences. We canconclude that this procedure of combined split gluteus maximusmuscle flap and rhomboid flap provides an excellent, effective,easy and feasible method of choice for reconstructing defectsof recurrent pilonidal sinus disease.