Background: Perianal fistula is a tract lined by infected granulation tissue that connects anal canal or rectum to the skin around anus. Its wall is made of inflammatory granulation as well as fibrous tissue. Perianal fistulae occur in approximately 10 out of 10,000 persons. Objective: The aim was to discuss the classification, diagnosis and management of perianal fistula with special emphasis on most recent trends. Patients and methods: The study was carried out on 50 Egyptian patients suffering from perianal fistula. Patients were managed in Sayed Galal University Hospital. The study was controlled prospectively. Ethical approval from the local Ethics Committee of Surgery Department was obtained. The patients were divided into two groups group A diagnosed by endoanal U\S and B by MRI fistulogram. Results: The current results on difference between Seton operation and other types. Regarding surgical data, there was localization of the internal opening occurred in 60% of patients operated with Seton technique. Among those operated with Seton technique, 80% had no complications, while recurrence occurred in 13.3%. Conclusion: In this study, seton technique was the best surgical technique in management of perianal fistula with less post-operative complication than other techniques.