This study was attempting the treatment of complex anal fistulae via application of negative pressure on the fistulous track. Negative pressure may assist fistula drainage and promote healing. In case of fulfillment of obliteration of the fistulous tract via this vacuum-assisted closure, classic surgery can be completely avoided with all its complications.Anal Fistula is an abnormal passage between the interior of the anal canal or rectum and the skin surface.The most appropriate management of anorectal sepsis is to eradicate the tract and drain the sepsis while preserving fecal continence. Multiple techniques have been used, including fistulotomy and fistulectomy, various types of flaps, instillation of fibrin sealant or stem cells and plug positioning. This high number of available methods due to the lack of universal success of any single treatment or any combination of treatments.The application of controlled levels of negative pressure has been shown to accelerate debridement and promote healing in many different types of wounds.Application of negative pressure on the fistulous track aimed at assisting fistula drainage and promoting healing through improvement of blood supply and activation of formation of healthy granulation tissue. In case of fulfillment of obliteration of the fistulous tract via this vacuum assisted closure (VAC), classic surgery can be completely avoided with all its complications.