Introduction: The perianal abscess recurrence is a common complication after the incision and drainage (I&D) intervention. We aimed to study the effect of other perianal diseases on treatment outcomes and recurrence of the perianal abscess in patients who undergone incision and drainage. Methods: During a retrospective study, in a two-year period, patients with perianal abscess underwent incision and drainage (I&D) enrolled study. Patient’s demographic features and abscess characteristics including location of the abscess, abscess superficial or deep position in pelvis, presence of the concomitant fistula and in hospital admission features such as length of hospital admission and postoperative pain severity recorded. Results: Perianal abscess recurrence was significantly higher in patients suffering Fischer lesion and fistula compared to patients without recurrence (P= 0.032 and P< 0.001). There was no significant correlation between abscess recurrence and postoperative complications, however, perianal fistula recurrence was significantly higher in patients who had previous history of the perianal fistula (P= 0.001). Patients with Fischer lesion had 25.35 times higher odds to exhibit abscess recurrence compared patients without Fischer. Previous history of the perianal fistula was associated with an increased likelihood of exhibiting perianal abscess recurrence up to 42.44 times higher odds. Conclusion: Patients with perianal abscess candidate to undergo incision and drainage suffering preoperative perianal fistula and Fischer lesion are at higher risk for development of the abscess recurrence.