Perineal scarring is common after the healing of more serious burns and trauma, as well as after surgery for some anorectal diseases, such as high-grade complex anal fistula, perineal sweat glands, perineal necrotizing fasciitis, etc. Most cases requiring revision are those with uncomfortable symptoms, such as scar contracture, anal deformation, inconvenient anal cleaning, easy retention of dirt, painful discomfort in the buttocks after sitting for a long time, etc. The most typical is the webbed scar contracture formed after the healing of horseshoe fistula, which covers the anal opening and causes local discomfort after sitting for a long time, or the inconvenience of wiping and flushing after stooling; in addition, the perineal necrotizing fasciitis and perianal sweat glanditis, which are more serious infectious diseases in the anorectal department, can be cured by surgery. In addition, patients with more serious infectious diseases such as perineal necrotizing fasciitis and perianal sweat adenitis have heavy lesions and a wide range of lesions; in addition to some more serious perineal burns and trauma, these patients often have more serious scarring after recovery, or different degrees of anal deformation, causing local discomfort or inconvenience in cleaning the anus after stool. The surgical methods are divided into two major categories: skin grafting and flap methods. The former is divided into various types according to the thickness of the skin flap, with the advantages of easy operation, low cost and short treatment course, and the disadvantages of exact postoperative pressure fixation, easy non-viability of the skin flap and unsuitable for deep tissue repair. The latter includes local arbitrary flaps, tipped flaps and myocutaneous flaps, which are more suitable for simple webbed scars and are simple and less costly in terms of time and economy, while tipped flaps and myocutaneous flaps are suitable for deep tissue repair and have good elasticity, but are bulky in appearance and less suitable for repair of shallow perineal defects. In recent years, related studies at home and abroad have found a variety of surgical methods, which also reflect the comprehensive decision-making concept of continuous improvement and joint application. For the repair of perineal perineal scar, skin grafting or local flap transfer can often achieve better results with easy operation, low cost, and short treatment course, while in case of deep defects, the combination of tipped flap or myocutaneous flap transfer can be considered, which is slightly more complicated and often requires multiple operations. In practice, it is necessary to combine the patient’s scar type and treatment desire to choose the appropriate surgical method flexibly.