Abstract: Fistula-in-ano connects anal canal to perianal skin producing persistent seropurulent discharge which may be quite discomforting to the patients. The condition has variable clinical presentations, histopathology, management options and postoperative complications, to which a clinician must be well versed with. This study was conducted over a period of five years in a tertiary care hospital. Detailed history, clinical examination, postoperative assessment, histopathology and magnetic resonance imaging findings were recorded. Significant observations were: previous surgery for anorectal abscess in 53.3%; single and multiple external openings in 80% and 20% respectively; 82.67% low fistulae and 17.33% high; 47.1% intersphincteric, 35.5% transsphincteric, 9.8% suprasphincteric & 7.6%extrasphincteric. Overall 77.78% underwent fistulectomy and post operatively, 9.3% developed discharge, 2.2% had wound bleeding and 0.4% developed incontinence. Histopathologically, 2.22% cases revealed tubercular origin. Hence, clinicoepidemiological and histopathological assessment of fistula in ano is not only essential to decide treatment modality but is also harbinger of complications and prognosis.