A retrospective review of 29 patients who had an anoplasty using the sliding House advancement flap was carried out to evaluate the efficacy and safety of this new technique. Long-term symptom relief and late complications were determined by telephone interview. Indications for anoplasty were: stenosis (21 cases), ectropion (four), Bowen's disease (two), keyhole deformity (two) and perineal fistula (one). A single House flap was performed in most patients, but eight required multiple flaps. Lateral internal sphincterotomy was performed concomitantly in 16 of 21 patients with anal stenosis. Postoperative complications included donor-site separation (14), urinary retention (eight) and sepsis (four). At a median follow-up of 28 months, 26 of 29 patients had improved and 24 were completely satisfied. House flap anoplasty can be used to correct many anoderm deficiencies with a high rate of success and patient satisfaction.