Background: Anal fissures are associated with spasm of the internal anal sphincter and pain. In present study we compared the efficacy of local application of 0.5% minoxidil and 2% diltiazem in symptomatic relief and healing of anal fissures.Methods: In this prospective, randomized, double blind study, a total of 100 patients with anal fissure were recruited, (50 patients in each group). Patients in group A received local applications of ointments containing 0.5% minoxidil, while patients in group B received topical 2% Diltiazem. Healing of anal fissure and symptomatic relief were observed and analyzed.Results: Rates of complete healing of fissure were similar in the two groups (minoxidil 27/50, diltiazem 29/50). Mean (SD) time taken for complete healing was significantly shorter with minoxidil (3.1 weeks as compared to diltiazem (4 weeks). Rates of pain relief were similar in the two groups. Stoppage of bleeding occurred more often with use of minoxidil than with diltiazem. No patient had systemic or local side effects.Conclusions: Treatment with minoxidil helps in faster healing of anal fissures and provides similar symptomatic relief as that of diltiazem.