A Rectovaginal fistula is one of the rare diseases accounting to 5% of anovaginal fistulas resulting in a distressing condition to the patient and a challenging task to her physician. Most fistulae arise in anal canal beginning distal to pectinate line and are more accurately be considered as anovaginal fistulae. This results in the uncontrolled passage of flatus or fecus through the fistulous tract into the vagina. It is a socially disabling condition for the patient. Further difficulties arise in planning the mode of treatment depending on the site and etiology of fistula. Treatment failures are because of contaminated operative site, high-pressure anal canal and usually procedures without diversion, creating a challenge for both the patience of the affected individual and surgeon`s skill.
Here we present a case report of a complex rectovaginal fistula which was successfully repaired by Modified Martius procedure.