This case series evaluated outcomes using a dermal regeneration template (DRT) and skin grafting for axillary hidradenitis reconstruction. Patients underwent complete excision of affected skin and placement of a DRT under negative pressure wound therapy. The DRT took well and skin grafting was successful with no complications. Management of axillary hidradenitis with complete excision and DRT/skin graft reconstruction appeared safe and effective in the pediatric population studied, with no DRT loss or hidradenitis recurrence. Larger prospective studies are still needed to confirm the efficacy of this reconstruction method.