Aim: to compare the effectiveness of limberg flap vs lay open in sacrococcygeal pilonidal sinus treatment. Methods: This randomized prospective study was carried out in the Government Hospital Sarwal, Jammu, India among 30 patients. Patients were randomized into two groups; group A with 15 patients was undergone wide local excision followed by limberg flap primary closure while the other group B with 15 patients was undergone wide local excision followed by Lay open flap (healing by secondary intention). Results: Mean age of the subject of the limberg flap group and lay open group was 22.42 years and 22.38 years respectively. 90% of the patient’s (27 patients) of the present study were males. In limberg flap group 53.3% patient achieved complete wound healing around 20-30 days while in lay open group 60.0% patient achieved complete wound healing around 51-60 days post operatively Conclusions: Excision with primary closure is a better modality than excision with lay open technique in treatment of pilonidal sinus.