© 2016 BMJ Publishing Group Ltd.Video-assisted diathermy ablation (VADA) and crystallised phenol application (CPA) have been independently suggested as minimally invasive treatment options for sacrococcygeal pilonidal disease (SPD). The failure rates may be 5-33% with either method, and these methods have a longer healing time when used alone. Thus, we combined the two methods to fulgurate the infected inner lining of the sinus after cleaning up the hair and debris, and to identify the anatomy of the pilonidal cavity in its entirety, including its branches and cavities, by video assistance; the ultimate aim was to disperse sclerosing phenol crystals for faster healing and potentially less or no recurrence. This is the first case in the literature that has been treated by combining CPA and VADA. The patient healed within less than a month, with no need for professional wound care, and was free of recurrence at 2-year follow-up.