Introduction: Pilonidal sinus is a chronic inflammatory condition which includes penetration of hair fragments into the skin. It rarely occurs in areas other than sacrococcygeal region. Case Report: A 19-year-old male presented with pilonidal sinus of the posterior part left temporal area of the scalp for one year duration treated by complete excision and primary repair. Conclusion: Although extremely rare, pilonidal sinus may occur in the scalp with unknown etiology.