It is now possible to define with precision the pathogenesis of anal fistulous abscesses. Common as well as rarer types of fistulas can be classified according to the anatomy of the anal canal. Identification and proper treatment of these conditions need a thorough systematic approach; knowledge of their symptomatology, anatomy and pathology is of paramount importance, and successful treatment is based on accepted surgical principles. A detailed description of the management of these fistulas is presented. Factors explaining recurrences are also mentioned.