In China, the incidence of anal fistula accounts for 1.67%-3.6% of anorectal diseases, and due to the diversity of its clinical manifestations and causes, clinical treatment modalities and outcomes have been reported differently, but surgery is the only treatment to eradicate anal fistula. The acronym for the principles of anal fistula treatment is SNAP, which stands for infection, nutrition, anatomy, and approach, respectively. Elimination of the infection is the first step in treatment – fistulas cannot heal if there is an infection; like other wounds, fistulas in a malnourished state are difficult to heal; the anatomy of the perianal area is complex and the opening and course of the fistula is often not well defined, which often leads to recurrence if the fistula is misidentified or if a branch is left behind; and finally, choosing the appropriate surgical approach is the key to successful treatment. Finally, choosing the right surgical method is the key to successful treatment. The fistula is not self-healing, and failure to treat it may lead to aggravation of the condition. If left untreated, fistulas often have recurrent abscesses, temporary closure of the fistula, and long-term chronic infection that can lead to complex fistulas; patients may experience pain, bleeding, fecal incontinence, cellulitis, and even systemic sepsis. Among the principles of surgical treatment, it is important to reduce the loss of the anal sphincter to protect anal function, while at the same time completely removing the source of infection to achieve the goal of eradication. Therefore, if the cure rate is pursued in treatment, a high anal incontinence rate will occur; and in order to reduce the incontinence rate, a low cure rate will result. In clinical work, surgical treatment of anal fistula is often associated with postoperative recurrence and anal incontinence. Therefore, sphincter-preserving surgery has become the mainstream procedure for the treatment of anal fistula because it can cure anal fistula with maximum protection of anal function. For example, trans-sphincteric fistula ligation, rectal nudging flap and biomaterial tamponade have been successful in the surgical treatment of anal fistula.