Aim: Sacrococcygeal pilonidal disease (SPD) is a chronic and uncommon entity. Extensive, complex and recurrent SPD is less frequent, and diverse treatment alternatives have been described. One of these is excision, followed by reconstruction with the rhomboid flap, as described by Dufourmentel. The aim of the present study was to report the results of a series of patients with extensive, complex or recurrent SPD operated on using Dufourmentel’s technique, in terms of postoperative morbidity (POM) and recurrence. Patients and Methods: The present study was a case series of patients with extensive, complex or recurrent SPD, operated on at the Clínica Mayor and Regional Hospital in Temuco, Chile, between 2000 and 2015, using excision, followed by a reconstruction with the Dufourmentel’s rhomboid flap. The outcome variable was POM measured at 30 days’ postoperatively using the Clavien–Dindo classification. Other variables of interest were surgical time, hospital stay, mortality and recurrence. The minimum follow-up time was 18 months. Descriptive statistics were used. Results: Ninety-five patients with extensive, complex or recurrent SPD were operated on in the study period. The median age was 21 years, and 56.8 per cent were female. The median surgical time was 60 min (45–90 min). POM was 13.7 per cent, seroma was 5.3 per cent, wound infection was 2.1 per cent and partial surgical wound dehiscence was 6.3 per cent. Mortality of the series was nil. Median hospital stay, follow up and recurrence were 4 days (3–5), 48 months (18–90 months) and 3.2 per cent, respectively. Conclusion: Dufourmentel’s technique applied to patients with extensive, complex or recurrent SPD was associated with adequate postoperative evolution in terms of POM and recurrence.