Pilonidal sinus is a long-standing chronic inflammatory condition which occurs most commonly in the sacrococcygeal area and it is rare in the penis. Two cases of penile pilonidal sinus in patients aged 25 and 28 years are reported and the literature is reviewed. The lesion is acquired and has to be distinguished from balanoposthitis, epidermal cyst and carcinoma. For pilonidal sinus to occur at this site, it is hypothesized that the coronal sulcus acts as a cleft where hair may accumulate and be driven into the shaft and prepuce by the natural movement between these two surfaces. One of our cases was associated with actinomycosis. Actinomycosis associated with pilonidal sinus of the penis is extremely rare and there are only two previous reports. It is suggested that pilonidal sinus may have been predisposed to the infection with the actinomyces organisms. Information stating that penile pilonidal sinus and actinomycosis may occur simultaneously is necessary to accomplish an early diagnosis.