In this review, we summarized the general characteristics of pilonidal sinus disease and details of rhomboid flap (RF) technique used in its treatment, and discussed the results of RF methods and its comparison with other techniques, principally with flap technique available in the literature. When performed studies are examined, RF technique has come into prominence nowadays with low recurrence and infection rates, and with a comfortable surgical technique. Recently, it has been anticipated that with the modification of this technique, the recurrence rate would be lower.