Acute paraproctitis is one of the most common purulent-inflammatory diseases of the rectum and perirectal tissue, accounting for up to 30–40% of all cases of proctological surgical pathology. The development of this disease in pregnant women presents a particular clinical and therapeutic challenge, as the inflammatory process and the need for surgical intervention are associated with risks for both the mother and the foetus. Physiological changes in the body of a pregnant woman - hormonal shifts, decreased immune reactivity, slowed intestinal motility, and venous stasis in the small pelvis -create favourable conditions for the development of paraproctitis and aggravation of its course.Despite the existence of uniform principles for the surgical treatment of acute paraproctitis, pregnant women require an individual, gentle approach that takes into account the gestational age, the degree of inflammation, the location of the abscess, and the general condition of the patient.