Background: Perianal fistula is a disease of antiquity. Even with all that work and research, started 
2500 years ago, or may be more, man didn't find “the" treatment for perianal fistulas. A lot of work is 
still required in a trial to reach that treatment. Objective: to evaluate Ligation of the intersphincteric 
fistula tract (LIFT) technique in the management of perianal fistula and follow up for possible 
complications as recurrence and anal incontinence. Patients and Methods: This is a prospective 
study conducted at Alazhar university hospital Assuit in the period from September 2017 to July 
2018. This study was designed to be a randomized controlled study, involving 40 patients with 
perianal fistula, 90.3% of them were males. Results: LIFT procedure was done to all patients with 
average hospital stay of 1.03 days (p=0.238), and follow up period of 10.5 (p=0.067) months. The 
cure rate was 86.7% (p=0.062), and the recurrence occurred in 13.3% (p=0.124) No cases of 
incontinence were noticed (p=0.038). Conclusion: Ligation of the inter sphincteric fistula tract 
technique is a feasible, minimally invasive, cheap and relatively easy procedure, which is safe and 
effective in same time. Colorectal surgeons as well as general surgeons, if they are planning to 
perform fistula surgery, should master this technique, as it can be done in most centers or hospitals 
even if it's poorly equipped, with minimal requirements, and satisfactory results. LIFT technique may 
become the gold standard in treating “uneasy" fistulas especially if it's Trans sphincteric. More 
randomized controlled trials are required, to prove that assumption or to dispute it.