Background: Fecal incontinence is a very distressing problem that affects quality of life and has social aspects. we aimed at reaching standardized and systematic lines of treatment to get the best results after perineal trauma and minimize the incidence of fecal incontinence. Methods: all patients we encountered that have acute perineal injury regardless of severity of the injury, mode of trauma , associated injuries, presence of anorectal injury. This study has been conducted in El-Minia university hospital, emergency unit including 32 patients in the period between March 2021 and December 2021. The main operative treatment applied in the study was immediate 1ry repair in the emergency setting using overlapping technique, with or without bowel diversion according to the evaluation of each individual case. The post-operative continence in the studied patients was assessed by a clinical score “modified Wexner score", on a scale from 0 to 24 , with 0 means complete continence and 24 means complete incontinence. Results: the mean age of the study was 23.9±11.2. The continence score after 6 months was ranging between 0 and 9 , with majority of the cases were between 2 and 6. Conclusion: there are many factors that influence the treatment outcomes regarding anal continence including the mode of trauma, type and site of injury and the operative procedure. Primary repair of traumatic anal sphincter injury can be done in the emergency settings, unless there is severe and extensive destruction of the perineal soft tissue. Long term follow up of the patients with anal sphincter injury and the use of recent diagnostic modalities such as anal manometry and endoanal ultrasound can lead to more dependable and precise results about fecal incontinence.