Anal fistula is a type of disease in which the rectum, anal canal and surrounding skin tissues are degenerated and connected, characterized clinically by repeated painful swelling and overflowing of pus from a paranal mass that does not heal. Once a fistula is formed, it is very unlikely to heal naturally, and even if the external opening is closed, the stabilization is still temporary, and acute morbidity can still occur when the body’s resistance decreases. Surgery is the only option for anal fistula patients. The greatest contribution of Chinese medicine to anal fistula surgery is the application of thread therapy to treat high anal fistulas, which reduces damage to the anal sphincter and effectively avoids various postoperative complications. The sphincter-cutting method is represented by the traditional classical anal fistula incision, which is the basic procedure commonly used in clinical practice. However, it is only suitable for low-level simple fistulas; the core of the sphincter-preserving approach is to remove the primary lesion and fistula tract without cutting the anal sphincter. The sphincter is preserved, so the function of the anus is well protected, and the damage is small and the treatment is short. In recent years, there has been in-depth research and great development in the surgical methods of Chinese medicine for anal fistula that preserves the sphincter, such as the use of simultaneous multi-side hanging thread for multi-sinus high complex anal fistula to control the time of dislodgement by controlling the tightness of the hanging thread, so as to achieve the purpose of simultaneous surgery, phased dislodgement and one time cure; for multi-branched complex anal fistula to treat by reasonable removal of the inner mouth, competent opening In order to avoid excessive damage to the perianal tissues and to protect the anus, the fistula can be treated with the use of wire dragging and drainage by reasonable removal of the internal opening, opening of the main entrance and opening of the branches. The first factor is surgery, but the second factor is postoperative medication change. A reasonable postoperative medication change helps to promote wound healing and prevent pseudo-healing and delayed healing or even recurrence. The treatment is effective in avoiding infection, ulceration and pain, and promoting timely wound healing. Although the problem of anal fistula eradication has been better solved and the protection of anal function has been greatly improved, the key to complete eradication of anal fistula and good protection of anal function lies in early surgery of anal fistula to avoid complication of the condition and thus reduce tissue damage to the anal canal.