Introduction and importance A patient presented with complex perianal fistula treated with fistula laser closure (FILAC) combined with suction catheters. Case presentation Male, 29 years old, presented in our department, presented with complex perianal fistula with a history of fistulectomy and tight seton for 6 months in another health facility. Intraoperative findings were a tract of 4,5 cm long, 4 external openings, and 1 internal opening. Definitive treatment of Fistula Laser Closure (FILAC) with 13-watt power laser diode produces by BIOLITEC German. Conclusion The patient recovers within 6 months. Promising results have been shown by combining FILAC and suction catheter for complex perianal fistula.