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A 41-year-old male, was diagnosed with Fistula in Ano. The biomedical diagnosis was confirmed with rectal examination and MRI Fistulogram which. MRI Fistulogram  revealed- well defined low anal linear simple fistulous tract 2mm in width and 2.5cms in length. Internal opening is at 6 o clock. The patient had been suffering from difficulty in passing stools and occasional blood-stained stools.  He tried Anal dilatation and internal medicines, as prescribed by the General Physician, but there was no significant relief. On medication, the amount of blood discharge reduced but there was purulent pus discharge. After having tried conventional treatments for a period of over 2 years, he decided to try Ayurveda. He approached Dr Sreelekshmi who diagnosed this condition as Bhagandara. Anal fissure and skin tag were also diagnosed on rectal examination. Ksharasutra was the primary treatment scheduled to heal the fistulous tract. With 1 primary threading and 4 Kshara Sutra threading, the fistulous tract healed completely within 4 months. The last follow up was recorded after 8 months. There was no recurrence reported and on examination, the skin was perfectly healthy. The bowels are normal and satisfactory.