Objective: To evaluate the efficacy of dapsone in the treatment of hidradenitis suppurativa refractory to therapy with oral antibiotics and isotretinoin. Methods: A retrospective review was performed of five patients treated with dapsone between 2002 and 2005. Clinical improvement and adverse events were recorded by the physician. Patients were asked to retrospectively rate their symptoms prior to and after starting dapsone. Results: Improvement was noted in all five patients within 4-12 weeks at doses ranging between 25 and 150 mg/day. All patients required maintenance therapy with dapsone at doses between 50 and 150 mg/day to sustain their disease control. Patient-reported symptoms improved in all cases after dapsone initiation, supporting physician observed clinical improvement. Treatment was well tolerated in all patients with no significant adverse effects noted. The median follow-up period was 24 months. Conclusion: Dapsone appears to be an effective and safe alternative therapeutic option for hidradenitis suppurativa and may be particularly useful for women in the reproductive age group.