Hidradenitis suppurativa (HS) is marked by dysregulation of multiple pathways leading to a chronic subclinical inflammatory state. Inflammatory cytokines IL-1β, IL-10, IL-17, IL-23, and TNF-α contribute to a constellation of comorbidities associated with HS. Patients with HS face higher risk of developing cardiovascular disease, type 2 diabetes mellitus, psychiatric disorders, IBD, spondyloarthritis, PAPASH, PAPA, and psoriasis. These comorbidities may present earlier or later than HS symptom onset, are not always improved or avoided with HS remission, and contribute to the overall poorer quality of life and higher morbidity and mortality that patients with HS experience. Often, HS patients are not aware of the other disorders discussed until they are screened, highlighting that dermatologists should screen or suspect the following comorbidities even in the absence of overt signs and symptoms.