This study was performed to determine the endosonographic features of the anal canal in normal children and to compare these findings with the endosonographic features in children with congenital anorectal malformations.Two groups of children were examined by anal endosonography (AES): group 1 ( n=30) were controls, and group 2 ( n=15) were children born with anorectal malformations.In the normal group, the sphincter elements were clearly visualised. The intersphincteric plane produced a double image, which differs from the adult appearance. Of 15 patients who had anorectoplasty, AES identified accurate placement of the neoanus within the sphincters in 13 and slight malposition in two patients.This study details the endosonographic appearances of the anal canal in healthy children aged from 1 month to 14 years. AES provided useful anatomical detail in patients following anorectoplasty.