The operative treatment of extra- and suprasphincteric anorectal fistulas is reported in three patients. This method, known as anoplasty, is applied following complete excision of the fistulous tract. A rectal mucosal flap is dissected and, after removal of the diseased mucosa, used to cover the fistula opening in the rectum in order to prevent continuous penetration of faecal material into the excised tract. Early experience with anoplasty indicates that this is an effective method in the management of high anorectal fistulas.