The aim of the study was to compare the outcome of patients underwent conventional fistulotomy for perianal fistulae (Lay open technique) versus fistulotomy with marsupilization. Twenty patients (20) with low,non recurrent perianal fistulae were randomly assigned as follow: (1)- Ten (10) patients were randomized to the the lay open (LO) group in which minimal amount of perianal skin on both sides of the incised tract was excised.This was designed to prevent premature skin healing before granulation from the depth of the wound was completed. (2)- Ten (10) patients were randomized to the marsupialization group (MS) group in which the anoderm and the skin at the wsound edges were sutured to the sides of the laid open fistula tract with interrupted Vicryl 2/0. The patients in both groups were not aware of the technique used at operation. Patients were followed up weeks after operation. The measured outcomes include operative time, postoperative blood loss, postoperative pain course, wound healing duration, wound infection, post operative hospital stay and shape of the scar. There was high statistical difference between marsupialization technique after fistulotomy and conventional fistulotomy regarding wound healing duration, postoperative pain, postoperative blood loss, wound sepsis, scar shape and postoperative hospital stay. Regarding postoperative pain, there was no difference shown in pain after 1 week while there was a significant difference in 1st and 2nd day. The study shows that marsupialization of perianal fistulae is superior to the conventional fistulotomy regarding wound healing duration, postoperative pain and blood loss, scar shape, wound infection and post operative hospital stay.