High anal atresia is a relatively common neonatal gastrointestinal malformation, which is caused by the obstruction of migration from the urogenital compartment to the cloaca during the 4th to 8th week of embryo, and is categorized into high, middle, and low by the relationship between the blind end of the rectum and the anus raphe muscle, with the blind end of the rectum located above the anus raphe muscle as the high position. Anal atresia is not easy to diagnose by prenatal ultrasound, and is currently thought to be associated with environmental pollution and medications taken during pregnancy, such as anticancer drugs, hypnotics and benzodiazepines. Depending on the location of atresia, it can be combined with different types of cavernous fistula, and in severe cases, cloacal malformation can occur. With the use of imaging and minimally invasive techniques in pediatric surgery, the diagnosis and management of congenital anal atresia has improved significantly over the past. The use of colostomy in middle and high anal atresia has greatly improved the survival rate of children with middle and high anal atresia. For more medical information about anal atresia, please consult a medical professional.