Endoscopic Pilonidal Sinus Treatment (EPiST) is a minimally invasive surgical technique used in the management of the chronic and recurrent pilonidal disease. It involves the use of a small camera to examine the pilonidal sinus, clean the sinus off any hair and debris, and, treat the sinus cavity. It is associated with less pain, quicker recovery, and earlier return to normal activities and has recurrence as low as seen with traditional pilonidal surgery.