The aim of this study was to evaluate the clinical outcome of coccygectomy those who were refractory to conservative treatment. Twenty patients (5 males, 15 females) underwent total coccygectomy when coccygodynia did not responding to medical treatment July 2013 to September 2018. All the patients timely attended with non-traumatic (n = 12) and traumatic (n = 8) cause with mean follow-up visits of 24 months (range 18-28 months). The outcome pain intensity was evaluated by visual analogue scale (VAS) in sitting position and during daily activities. Three patients had infection which improved after antibiotic therapy. The VAS improved from 6.4 ± 0.9 to 2.1 ± 0.9 for sitting and from 5.8 ± 0.9 to 1.6 ± 0.6 for daily activities. Improvement in pain and daily activities were significant at the final follow-up. Ninety percent patients were satisfied with the operation.