Male patients who present with pain in the buttocks are most commonly the result of perianal disease. Diseases that occur below the dentate line, which is a category of limbic innervation, are very sensitive to pain and are precisely localized, including perianal abscesses, fissures, fistulas, and acute thrombosed external hemorrhoids. It occurs mainly due to unreasonable dietary structure, frequent overeating, poor perianal hygiene, increased abdominal pressure for a long time, and the formation of hemorrhoids in obese patients, which can easily lead to aggravation of the lesion after prolonged sitting. On examination a significant swelling can be found around the anus, which is congested and edematous with tenderness. For acute thrombosed external hemorrhoids, surgical treatment should be promptly selected for removal, while perianal abscesses and anal fistulas should also be surgically incised, removed or drained, and anti-infection treatment is required after surgery.