摘要： Background and Objectives: An ideal treatment for pilonidal disease should feature a low recurrence rate, minimal incision, and rapid return to daily activities. We compared the outcomes of the well‐defined Karydakis technique (KT) and a combination of pit excision (PE) and sinus tract ablation using 1,470‐nm diode laser. Study Design/Materials and Methods: In this study, from January 2016 to January 2018, patients diagnosed with uncomplicated early‐stage pilonidal sinus disease were enrolled and were treated randomly, using KT (n = 28) or a PE/laser ablation technique (PE + LAT; n = 30). Results: The mean operative times were 36.4 (25–45) minutes in the KT group and 15.1 (12–20) minutes in the PE + LAT group. Postoperative Visual Analog Scale pain scores were 4.4 in the KT group and 2.1 in the PE + LAT group. The time periods to return to normal daily activities were 2.6 (1–5) days in the PE + LAT group and 12.8 (10–20) days in the KT group. The mean Likert satisfaction scores were 3.8 in the KT group and 4.8 in the PE + LAT group. The groups did not differ in terms of recurrence. Conclusions: Compared with the KT, the PE + LAT was associated with a shorter operative time, a more rapid return to normal activities, less pain, and a higher level of subjective satisfaction. We found that the PE + LAT was better than the KT for patients with early‐stage disease.