PURPOSE In order to prevent postoperative infection and recurrence of sacrococcygeal pilonidal sinus, the authors developed a modified Dufourmentel flap, involving the superior pedicles, and designed a descriptive prospective study to evaluate its efficiency. METHODS Between July 2007 and March 2014, 16 patients with sacrococcygeal pilonidal sinus were treated with an irregular quadrilateral excision and reconstruction by a modified Dufourmentel flap with superior pedicle. The duration of wound healing, presence of wound complications and permanent hypoesthesia, and recurrence rates were recorded and assessed. RESULTS None of the patients developed flap necrosis or wound infection postoperatively. The duration of wound healing was 7.2 ± 2.9 (range = 6-15) days. Wound dehiscence was demonstrated in only one patient (6.3%). The mean follow-up period was 4 years and 2 months (range = 4 months-8 years and 8 months), whereby no permanent hypoesthesia or recurrence was detected. CONCLUSION The modified Dufourmentel flap with superior pedicle can be safely used as a treatment of sacrococcygeal pilonidal sinus, with excellent results.