Background <p>Sinus laser-assisted closure (SiLaC) is gaining popularity as a minimally invasive surgical technique to treat chronic sacrococcygeal pilonidal sinus disease (SPSD). However, long-term outcomes on this technique are rarely reported in the literature. This multicenter study aimed to report the mid-term outcome of a cohort of patients who underwent SiLaC treatment for primary or recurrent SPSD.</p> Methods <p>Patients with primary or recurrent SPSD were included in this retrospective cohort study. Data were collected from medical records, and a validated questionnaire was distributed to all patients at follow-up to assess symptoms, quality of life, and the need for additional surgery.</p> Results <p>A total of 231 patients were included, with a median follow-up of 33&#xa0;months (IQR 20–44): 128 patients underwent SiLaC for primary SPSD and 103 for recurrent SPSD. Additional interventions were required in 35 patients with primary SPSD (27.3%) and in 30 patients with recurrent SPSD (29.1%). Repeat SiLaC alone, i.e. no other surgical treatment than repeat SiLaC, was performed in 25 patients (19.6%) in the primary group and 22 patients (21.4%) in the recurrent group. Treatment failure, defined as persistent symptoms and/or the need for surgery other than SiLaC, occurred in 23 patients (18.0%) in the primary group and in 21 patients (20.4%) in the recurrent group. However, SPSD-related symptoms were low at follow-up, and quality of life measured by the SF-36 was reported to be even higher than in the general USA population, both in the primary and recurrent group.</p> Conclusions <p>SiLaC for primary and recurrent SPSD appeared to be a safe procedure with excellent symptom control and quality of life, with only 7.8% of patients in both groups requiring other surgical treatment than SiLaC.</p>