Hidradenitis suppurativa (HS) is a relapsing, chronic, debiliating skin disease with a characteristic clinical presentation of tender subcutaneous nodules, painful deep dermal abscesses, and sinus tracts in the apocrine gland-bearing regions. Medical treatment of HS consists primarily of antibiotics, corticosteroids, retinoids, antiandrogen therapy, immunotherapy and immunosuppressive agents. However, currently available medical treatments are insufficient and their efficacy is only transient. Therefore in recalcitrant HS, subdermal excision of the involved follicles and inflammatory process is the only curative treatment. We report a case of axillary hidradenitis suppurativa in a 21-year-old man. He presented with multiple painful 8.0 X 8.0 cm sized deep seated nodules and abscesses with sinus tract formation and scarring on the right axilla for 3 years. Although abscess drainage and intralesional corticosteroid injection with oral antibiotics were performed every year, the lesions were relapsed and exacerbated. Histopathological findings showed intense perifollicular infiltrate and abscesses composed of neutrophils. Also, granulation tissue-like changes with a mixed acute and chronic inflammatory infiltrate were shown in the dermis. He was diagnosed with recalcitrant hidradenitis suppurativa on the right axilla so we treated with subdermal excision. He had no recurrence after subdermal excision until now.