Abstract Pilonidal sinus is a condition affecting young people. Several management methods are available. The two popular approaches are laser ablation and open techniques. This study aims to assess the recurrence rate after both techniques. This is a government and private hospital setting. Patients are included if they are diagnosed with pilonidal sinus, between the ages of 16 and 70, and have never had surgery before. Diabetic patients and patients with immune deficiency status who are younger than 16 or older than 70 are excluded. The operations are done by senior consultant surgeons. Patients are seen for 4 weeks or 3 months and discharged if there are no complications. 190 and 184 patients were selected for the laser and open groups, respectively. There are 142 men and 42 women in the open group compared to 140 men and 50 women in the laser group, with p-value: of 0.472. There was no significant difference in age, body mass index, or obesity between the two groups. There is a significantly higher recurrence rate in the laser group value: <0.00001. No significant difference in the recurrence rate for one or more than one opening disease within the open group. The laser technique is associated with a higher recurrence rate compared to the open rhomboid flap technique. One opening pilonidal sinus is significantly showing better results within the laser group but no significant difference in the open group