This review covers the recent literature on various treatment strategies, associated comorbidities and diagnosis of hidradenitis suppurativa (HS). HS is a chronic inflammatory skin condition that can pose a considerable challenge to treat. HS is associated with various comorbidities, such as metabolic syndrome and psychiatric disorders. Data demonstrates a significant diagnostic delay, which may contribute to the long preceding treatment history with multiple drug classes and treatment series before initiation of biologic therapy. Although adalimumab, secukinumab, and bimekizumab are the only approved biologics by EMA for moderate to severe HS, many promising biologics are currently being investigated for moderate to severe HS.