Summary: Background: Hidradenitis suppurativa (HS) is a chronic, debilitating, heterogeneous disease requiring different treatment approaches. Recently, we refined the classic Hurley classification into a seven‐stage classification in order to guide these treatment choices. This new classification subdivides Hurley stage I and II into three substages, namely mild (A), moderate (B) and severe (C) HS disease. Hurley stage III is not subcategorized and is always severe. Objectives: To investigate the correlation between the given severity grades of Hurley I and Hurley II in the refined Hurley classification, and the patient‐reported quality of life and physician‐assessed objective severity score. Materials and methods: In this cross‐sectional study, patients with HS participating in the observational cohorts of two Dutch tertiary referral centres were included before June 2017. The patient‐reported Dermatology Life Quality Index (DLQI) and physician‐assessed International HS Severity Score System (IHS4) scores were compared between the refined Hurley stages. Results: In total, 433 patients were analysed. DLQI and IHS4 scores increased within Hurley stage I and II from A through C. There was a significant positive correlation of DLQI and IHS4 with increasing refined Hurley substages [refined Hurley stage I (A, B and C) to DLQI: rs = 0·259, P < 0·001 and refined Hurley stage II (A, B and C) to DLQI: rs = 0·185, P = 0·010; refined Hurley stage I (A, B and C) to IHS4: rs = 0·603, P < 0·001 and refined Hurley stage II (A, B and C) to IHS4: rs = 0·532, P < 0·001]. Conclusions: The refined Hurley classification accurately correlates with HS severity assessed by both patients and clinicians. Therefore, the refined Hurley classification is a useful tool for the quick assessment of severity in HS. What's already known about this topic? Hidradenitis suppurativa (HS) has an enormous impact on the patient's quality of life.The refined Hurley classification has been developed as a treatment guide combining medical and surgical approaches based on the number and nature of lesions, locations and inflammatory activity. What does this study add? The refined Hurley classification accurately reflects disease severity according to both patient‐reported quality of life (DLQI) and objective severity scores (IHS4).The refined Hurley classification enables a specific phenotype within patients with Hurley I to be classified as severe disease and to be treated accordingly.The refined Hurley classification is an easy and useful tool to assess severity in HS in daily practice. Linked Comment: Ingram. Br J Dermatol 2019; 180:991–992. Respond to this article [ABSTRACT FROM AUTHOR]