Introduction. As of today, many options for conservative and surgical treatment of patients with pilonidal cysts have been developed. Our studies on the use of laser radiation in the treatment of epithelial coccygeal passage, which began in 2007, showed its positive clinical effect, which is expressed in a decrease in the number of complications and relapses. The principle of the method is the thermal ablation of the walls of the coccygeal passage with laser radiation. The aim. To study the effect of high-intensity laser radiation on the tissues of pilonidal cyst in patients with epithelial coccygeal passage, in order to improve the results of their treatment. Materials and methods. The study was conducted from 2018 to 2021. The patients were divided into 2 groups depending on the type of surgical treatment. The first group consisted of 124 patients who underwent cyst excision with primary sutures. The second group included 60 patients who underwent laser-induced interstitial thermotherapy. To study microcirculatory changes in the tissues of the pilonidal cyst while doing operational injury, SPECTROTEST (Spectro Analytical Instruments, Germany) spectrometer was used. Results. We have revealed changes in microcirculation and tissue saturation parameters depending on the type of surgical treatment. In the first group, a statistically significant microcirculatory and tissue saturation disorders were found in the walls of postoperative wounds. In the second group, microcirculatory disorders were less pro-nounced, and their normalization occurred much earlier. This indicates the absence of ischemia of the surrounding tissues around the treated area. Temperatures in the walls of pilonidal cysts at laser-induced interstitial thermom-etry vary from 56 to 65 °C, which are the temperatures of destruction of proteins that make up the structure of the cyst walls. On the surface and in the tissues surrounding the cyst, the maximum recorded temperature was 40 °C, and this does not cause protein destruction. Conclusions. High-intensity laser radiation leads to obliteration of the cystic cavity, the formation of scar tissue, the elimination of specific symptoms and the decrease in the risk of recurrence of pilonidal disease, which is confirmed by spectroscopy, thermometry and histological studies.