BACKGROUND.      Pilonidal sinus disease has been treated for a long time with conventional open excision technique. The transposition flap has been pleaded for treatment of this condition.AIMS AND OBJECTIVE.The aim of this study was to treat sacrococcygeal pilonidal sinus by rotation and transposition flap in terms of incidence of post–operative pain, total hospital stays, total recovery time, complications and recurrence rate.METHODS AND MATERIALS.Prospective study conductedfrom September 2016 to July 2017 in a 30 Patients having sacrococcygeal pilonidal sinus, who were admitted in the surgical department of G.S. Medical college and hospital, Hapur, Delhi.All the patients were prepared 2 hours before the surgery.were operated under spinal anaesthesia, in prone position. All the patients were males and fascio cutaneous flap were used. In some cases, rotation flap and in some transposition, flap were used for coverage of defect.Pre–operative prophylactic single shot of antibiotic. Visual analog scale was recorded 8^th hourly and the mean value was calculated for each POD1, POD2, POD3.RESULTAll the patients in this study were males. Maximum number of patients (56.66%) were in the age group of 20–35 years and the remaining (43.33%) were in the age group of 36 –50 years. The mean age was 29.34 years. Nearly 43 % of patients were overweight and obese (BMI>25kg/m²) and 32% of patients were with abundant hair. The post–operative pain assessment was done by VAS and the mean was taken on POD_S 1,2 and 3. It was found that the mean post–operative pain score was higher on POD 1,2 and 3 but it was statistically significant as regard to mean post–operative pain on POD 2 (p<0.05) and 3 (p<0.01). There were no recurrences.CONCLUSIONFascio cutaneous flap have low morbidity, easy to raise and inset in the defect after excision of pilonidal sinus. Both types of flap have low recurrence, equally good and depends on skin laxity.