Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition primarily affecting areas with a high density of apocrine glands, such as the axillae, groin, and perianal regions. It is characterized by recurrent painful nodules, abscesses, sinus tracts, and scarring. The pathophysiology of HS involves follicular occlusion and a dysregulated immune response, with overactivation of the IL-17 and TNF-ɑ pathways leading to chronic inflammation. Common risk factors include obesity, smoking, and a family history of HS. Histopathologically, HS presents as follicular occlusion with perifollicular inflammation and chronic sinus tract formation. Treatment options include topical and systemic therapies, with recent advances in biologic treatments like secukinumab, an IL-17A inhibitor, offering promising results for reducing inflammation and lesion formation in moderate to severe HS. This chapter reviews the incidence, pathophysiology, clinical presentation, histopathology, and treatment options for HS, emphasizing the role of biologic therapies, such as secukinumab, in managing this challenging condition.