Hidradenitis suppurativa (HS) is a chronic relapsing disease that frequently causes disabling pain, diminished range of motion, and social isolation. In advanced cases of HS, aggressive excision of the involved apocrine tissue with subsequent reconstruction is the defi nitive treatment. Here, we present our recent experience of using split-thickness skin graft (STSG) for managing an extensive defect following wide surgical excision of axillary HS lesions. Adequate wide excision of the infected tissue ensures complete skin-graft take while allowing full shoulder mobility, thereby minimizing undesirable outcomes. No limitation of shoulder joint or disease recurrence was observed during one year of follow-up. This method has satisfactory aesthetic and functional results as well as low donor site morbidity for treatment of repeated extensive HS of axilla. © 2013 JMS.