Pilonidal disease commonly is seen by all primary care practitioners, and guidelines for office management and referral are provided. Less commonly seen entities, such as hidradenitis suppurativa, anal cancer, and Bowen's and Paget's diseases, also may affect this anatomic area. Knowledge that they may be encountered here helps guide the practitioner to the proper diagnosis and management. Lastly, foreign bodies are sometimes seen in the anorectal area, and information about appropriate steps to take are outlined.