Horse shoe fistula is a descriptive term that indicates the unusual pathway of the spread of an abscess originating in the deep posterior anal space, manifesting with multiple openings. The treatment of such fistulae is more complex due to the possibility of faecal incontinence and delayed healing as a result of sphincterotomy. This study is of a 45 year old male patient, who had diabetes mellitus, presented with multiple external fistula openings at 4 o clock and 5 o clock position at the left side and one at 8 o clock position at the right side with pus discharge since 2 months. The patient was successfully treated using Ksharasutra (KS) and De-roofing technique, without any complications over a span of four months.
Key words: Horse- Shoe Fistula, Ksharasutra, Parikshepi, Bhagandhara,De-roofing