Hidradenitis suppurativa (HS, also known as acne inversa) is a chronic inflammatory skin disease that is characterized by formation of nodules and at later stage tunnels in skin. Such lesions are painful and commonly accompanied by secondary infections that result in scarring and unpleasant smell. As HS occurs primarily in skin folds the patients postpone visits to physicians. Furthermore, since the clinical presentation of HS is variable the disease is often misdiagnosed, correct treatment is commonly delayed and HS patients suffer from severe psychosocial stress and decline in quality of life. The purpose of the current review was to point out the key features of this potentially debilitating disease to facilitate its early diagnosis and efficient treatment. In addition, the pathophysiological features of HS, its clinical presentation and treatment options are discussed.