INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic, auto-inflammatory skin condition and is associated with several comorbidities. Previous studies report variable prevalence rates of HS, depending on the methodology, however the exact prevalence remains unknown. OBJECTIVES: To estimate the prevalence of HS in a large population-based cohort in the Northern Netherlands, and to compare HS patients to the general population, investigate characteristics and identify potential associated comorbidities. METHODS: Data was collected through a cross-sectional survey-based study within the Lifelines Cohort Study (n=167,729), based on the general population located in the Northern Netherlands. A digital self-reported questionnaire was developed consisting of validated questions for determining HS. RESULTS: Among 56,084 respondents, the overall prevalence of HS was 2.1% [95% CI 2.0 to 2.2]. The respondents with HS had a lower socioeconomic status than the controls (p<0.001) and were more frequently current smokers (p<0.001). Several new significant associations in HS patients were revealed, such as fibromyalgia [OR=2.26; 95%CI 1.64 to 3.11], irritable bowel syndrome [OR 1.63; 95%CI 1.18 to 2.26], chronic fatigue syndrome [OR=1.72; 95%CI 1.06 to 2.78] and migraine [OR=1.48; 95%CI 1.11 to 1.96]. Fibromyalgia and chronic fatigue syndrome remained significantly associated with HS in the multivariate analysis after adjusting for age, sex, BMI, smoking status and socioeconomic status. CONCLUSION: Our study showed a higher prevalence of HS in the Northern Netherlands compared to the overall estimated prevalence of 1% and identified several new associated comorbidities.