Introduction: Saccro-Coccygeal Pilonidal Sinus (SCPS)1 is a common affliction seen mostly in young slightly obese hirsute males. There are many ways to manage this, most commonly being excision and leaving a raw area to heal by secondary intention. This procedure necessitates long periods of dressing which causes much distress and inconvenience to patients. Also this method does not address to one of the basic causes of Sacro-coccygeal pilonidal sinus (SCPS) which is suction effect of a deep natal cleft. The other procedures are difficult to master and have their own set of issues for successful management. Methods: This was a prospective study was carried out in the Department of Surgery of a secondary care government hospital for a period of 18 months (July 2016 to December 2017). The total number of cases of SCPS surgery was 50. Here the focus is on management of SCPS by complete excision of infected tissue and on table primary coverage of defect using a Limberg flap with a follow up for 12 months. Results: Of the 50 patients operated there was seroma, wound infection and partial necrosis of flap in 13 patients. However there was no recurrence. When the wound was large and wound infections too were common in large wounds > 6cms transversely and 7cms vertically. Conclusions: SCPS disease can easily be managed by rhomboid excision and reconstruction by Limberg flap as it addresses the cause of sinus and has low complication rates, short hospitalisation, no recurrence rates, earlier healing and shorter time off work. The surgery can be easily mastered. However the dimensions of defect must be <6cms, lower end should be away from anal verge and preoperatively the sinus must be lavaged to have low infection rates and flap tip necrosis. We recommend Limberg flap as preferred surgery for cases of the Saccro-coccygeal Pilonidal sinus.