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Fistulas in ano is an abnormal connection between anal canal and perianal skin. There are two subtypes occur on the basis of course of fistulous tract and involvement of external anal sphincter simple and complex. Complex fistula is challenging to manage due to risk of recurrence and fecal incontinence even in experienced hands. A myriad of surgical procedures are available in armamentarium of surgeon for ages and placement of seton is the one of answer to this complex clinical entity. Seton placement preserve the fecal continence and prevent recurrence. We here presenting our experience of managing 116 cases with seton placement over three years duration at a tertiary care centre. In our series recurrence rate was around 10% without any fecal incontinence. Seton placement is a safe option for managing complex fistula in Ano.
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