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Background: Hidradenitis suppurativa (HS) and atopic dermatitis (AD) are both chronic inflammatory skin diseases. An association between these 2 conditions can have important potential implications for elucidating pathogenesis, disease course, and treatment., Objective: To investigate the association between AD and HS., Methods: We performed a retrospective cohort study of patients seen at Duke University Medical Center from 2007 to 2017 who had AD compared with a control group without an AD diagnosis. The association of AD and HS was evaluated using a logistic regression model after adjusting for other confounders including age, sex, and race., Results: Of 28,780 patients with an AD diagnosis, 325 (1.1%) were diagnosed with HS compared with 76 (0.2%) within the 48,383 patients in the non-AD group. An adjusted logistic regression model demonstrated an increased odds ratio of having HS diagnosis in the AD group as compared with the control non-AD group (odds ratio: 5.57, 95% confidence interval: 4.30-7.21, P  < .001)., Limitations: This was a retrospective study performed at a single institution with the possibility of surveillance bias being present., Conclusions: Patients with AD are more likely to be diagnosed with HS than patients without AD. Further research is needed to understand the pathophysiologic mechanism and potential treatment implications., Competing Interests: Dr Macleod consulted for Silab when she was an employee at Duke. The MacLeod laboratory has previously received funds from Silab Company; funding from this partnership was not directly used for this study. Silab did not have any influence on the content of this project. Dr Macleod is also consulting for the LEO Foundation. The spouse of Dr Macleod is employed at Precision Biosciences and has stock options. Dr Jaleel is an investigator for UCB and reported consulting for Eli Lilly and Chemocentryx and receiving honoraria. None of the content or the decision to publish has been affected by the authors' involvement with Eli Lilly, Silab, Chemocentryx, Precision Biosciences or the LEO foundation. Drs Kaakati, Tanaka, Liu, Ward, and Green have no conflicts of interest to declare., (© 2021 by the American Academy of Dermatology, Inc. Published by Elsevier Inc.)