A recto perineal fistula is a condition in which the rectum communicates with the vagina and may be congenital or acquired as a result of surgery, childbirth or infection. Recto perineal fistula is generally referred to as rectovaginal fistula. In women, the vagina is adjacent to the bladder and urethra in front and the rectum in back. The presence of a congenital or acquired channel between the rectum and the vagina is known as a rectovaginal fistula, which is mainly characterized by vaginal defecation. Congenital rectovaginal fistulas usually coexist with anal atresia and usually require surgical treatment around the age of half a year. Acquired rectovaginal fistulas are usually caused by surgery, childbirth and infection. The use of an anastomosis for rectal surgery, improper injection of sclerosing agents for hemorrhoid surgery, and pelvic surgery that injures the rectum can lead to rectovaginal fistulas. Labor and delivery injuries are the cause of most rectovaginal fistulas. Rectal tears and perineal paracentesis during delivery may lead to fistulas. Inflammatory conditions such as perianal abscesses and cancers such as rectal cancer ulcers may also lead to fistulas. It is recommended that patients with rectovaginal fistulas seek prompt medical attention, undergo an examination to identify the cause, and follow the doctor’s instructions for treatment.