Hidradenitis suppurativa (HS) is a chronic, inflammatory, scarring disease that occurs most frequently along the milk lines of the body from axillae to groin, is most common in the second and third decades of life, and is rarely observed before puberty. It disproportionately affects women and is associated with a host of comorbidities and dramatically reduced quality of life. The delay from HS symptom onset to diagnosis is approximately 7 years, with drastic consequences for patient well being. Early diagnosis and treatment are of paramount importance. While several nonpharmacologic, pharmacologic, and surgical treatment modalities exist for HS, only one agent, adalimumab, has been approved by the US Food and Drug Administration for this indication. Lifestyle modifications, dietary changes, patient education, and psychosocial support are important components of HS therapy.