Pilonidal disease and hidradenitis suppurativa are chronic inflammatory diseases that affect young patients and can have a serious impact on their quality of life. The association between them was frequently reported but not well documented. This study aimed to determine the prevalence and characteristics of inflammatory skin lesions located in the intergluteal fold and axillae of patients with hidradenitis suppurativa and those with pilonidal disease. In retrospective manner the study based on data collection from records of a cohort of patients with hidradenitis suppurativa without histopathology and patients with pilonidal diseases with or without histopathology who had been managed in Almikhwah General Hospital, KSA during the period from January 2014 to April 2020. A total of 391 patients were recruited, 224(57.3%) with pilonidal diseases (Group A) and 167 (42.7%) with hidradenitis suppurativa diseases (Group B). Their mean age was 27.5 years (p=0.3). In group A, the lesions were found in sacrococcygeal region whereas in group B, it was found in axillae and sacrococcygeal region. Coincidences of the diseases were observed in 79 (20.2%) patients. In conclusion, it should be borne in mind that the pilonidal sinus can be a non-localized type of hidradenitis suppurativa.