Perianal abscesses constitute a common perianal infection frequently encountered in emergency medical settings. Their development is influenced by several predisposing factors, including inflammatory bowel disease, smoking, and HIV infection, with peak incidence typically observed in individuals around the age of 40. The pathogenesis of perianal abscesses is attributed to obstruction of the ducts of the anal glands, which facilitates bacterial proliferation and subsequent inflammation. Anatomically, perianal abscesses are classified into ischiorectal, intersphincteric, supralevator, and perianal; the latter being the most frequently encountered. The predominant clinical manifestation is localized perianal pain, although systemic symptoms may also be present. While medical history and physical examination are generally sufficient for diagnosing uncomplicated perianal abscesses, imaging modalities should be employed in cases with atypical presentations, suspected occult supralevator abscesses, complex anal fistulas, or perianal Crohn’s disease. The primary treatment for perianal abscesses is surgical incision and drainage. Perioperative antibiotic prophylaxis is indicated for patients with specific comorbidities, in accordance with current clinical guidelines. Antibiotic therapy is generally reserved for cases complicated by cellulitis, systemic infection, or immunosuppression, with empiric antimicrobial regimens determined based on patient risk stratification and local antimicrobial resistance patterns. Although perianal abscesses are considered benign, their clinical course is complicated by variable rates of recurrence and fistula formation. Therefore, patients undergoing drainage procedures require meticulous follow-up and close clinical monitoring to identify and manage potential complications effectively.