INTRODUCTION: Hidradenitis suppurativa (HS) is a skin disease that significantly impacts patients' quality of life. There are still uncertainties surrounding its epidemiology, natural history, and the safety and effectiveness of existing treatments. The Spanish Academy of Dermatology and Venereology has promoted the creation of a Spanish Registry of patients with HS (REHS). The aim of this article is to present the REHS and provide the initial results obtained. METHODS: The REHS is a prospective, multicenter, observational study that collects the clinical and epidemiological characteristics of patients with HS, as well as the safety and effectiveness of the medical and surgical treatments received. RESULTS: Between June 2023 and June 2024, 359 patients were recruited from 23 Spanish centers. The average age of the patients is 37 years, and 53% of them are women. Over 70% of the patients are smokers or former smokers. One third have a family history of HS. The most frequent sites of disease onset are the axillae and groin. Median baseline IHS4 at recruitment was 4 (p25-p75=1-9), HiSQOL was 20 (p25-p75=8-36), and BMI was 27.3 (p25-p75=24-33.2). At least 82% of patients have received antibiotic therapy for their disease, and almost 20% a biologic drug. CONCLUSIONS: We present data from the first patients enrolled in the REHS, which will allow for the generation of evidence on the natural course of the disease, as well as the effectiveness and safety of treatments in HS.