Highly complex anal fistula requires multiple hookups, the exact number of hookups is related to the complexity of the fistula. Anal fistula is the rectum or anal canal and perineal area of the skin channel infection, usually with incision drainage, perianal abscess breakthrough, etc., anal fistula by the external mouth, internal mouth and fistula three parts, anal fistula can be divided into simple anal fistula and complex anal fistula. The high complex anal fistula belongs to a very serious one, manifested by the existence of multiple fistulas and fistulas at the same time, and the location of the main fistula in the sphincter outside the anus in the deep. Due to the multiple fistulas and fistulas, they can be treated in conjunction with hanging thread treatment and fistulotomy treatment. In the case of hanging wire treatment, it is necessary to deal with them one by one, in addition, it should be excluded that there is false healing and unclean treatment. Therefore, high complex anal fistula, need to hang line several times to be able to treat, serious cases may need 3~4 times of treatment. It is recommended that patients with high complex anal fistula, early medical examination to clarify the severity of the disease, strict compliance with the doctor’s instructions for treatment, good postoperative care, regular review.