Pilonidal sinus disease (PSD) is common in adults, but it may also develop in adolescents. The intergluteal groove is a deep moist area in which broken hairs and foreign bodies can collect, often leading to infection. Only a few papers have been published considering PSD in children. For the present study, we retrospectively examined the data of operated patients with PSD. From that review, it appears that high body mass index (BMI) might be a risk factor for the development of PSD and its complications in older children. Fourteen young patients (12 males, 2 females, 12-18 years of age) underwent surgery for PSD. According to the BMI-for-age, eight of these patients (57, 1%) were overweight or obese. Five of them (35.8%) developed mild to moderate postoperative complications. Symptoms recurred in one patient (7.1%) whose BMI was considered as overweight. In patients with normal weight no early or late complications developed. Our findings suggest that high BMI in adolescents is a significant risk factor in the development of both symptoms and complications of PSD after surgical treatment.