Mast cells (MC) have been observed in hidradenitis suppurativa (HS) lesions. Their potential role in the pathogenesis of HS is unknown. The aim of this study was to assess the number and distribution MC in HS lesions, and its association with disease and itch severity. We studied biopsies from HS-lesions and perilesional skin from 34 HS patients. The samples were stained with CD117 and toluidine blue, and the number of MC determined semi-quantitatively (40?� magnification). The distribution of MC was also noted. The clinical features of the disease were extracted from patients' case records and a questionnaire-based database. MC were present to a greater degree in HS-lesions than in perilesional skin (P?=?0.004). Disease severity (Sartorius score) was correlated to with MC count and itch when adjusted for sex and age (P?=?0.042). Duration of the disease could not been significantly correlated with MC count. A positive correlation between MC count and HS activity was detected, suggesting a potential link between MC and HS.