Background and Objective: Malignant degeneration of pilonidal sinuses of the sacrococcygeal region is rare but quite serious, as the tumor soon perforates the sacral fascia and becomes adherent to the irregular posterior aspect of the sacrum, making it very difficult, if not impossible, to remove all neoplastic tissue by conventional surgery, hence the high recurrence rate and poor prognosis.A new cryosurgical technique to treat advanced sacrococcygeal pilonidal cancer is herein presented.