The causes of anal itching in the middle of the night are the following: 1, may be the itching caused by anal parasites, mostly seen in pinworms, pinworms crawl out of the outside of the anus to lay eggs after 12 pm when the patient’s body is relaxed and the anal sphincter is relaxed, so there will be symptoms of anal itching in the middle of the night. 2, may be due to human papillomycetes caused by acromegaly, preferably around the anus, there will be a foreign body feeling, pain, itching,