Nine of 10 patients operated on by a single surgeon were studied. Hospital records, radiographs, and a postal survey were used. Follow-up averaged 56 months. Age at operation averaged 32.5 years. There were six males and three females. Symptoms had been present for 7 months to 14 years and all patients failed a course of non-operative therapy. All patients underwent a total coccygectomy by subperiosteal dissection through a longitudinal midline incision. There was one postoperative wound infection. All patients were satisfied with the surgical scars. Three patients reported "complete" pain relief, five reported "marked improvement," and one was "slightly improved." All nine patients were satisfied with the operation and would choose to have the surgery again.