Background: Fistula in Ano is one disease which is easy to diagnose but difficult to cure as patients report in very late phase of the disease and it leads to problems. Aim of this study was to determine the etiology, clinical presentation, efficacy of different surgical approach, early and late post-operative complications, and recurrence rate in cases of fistula in Ano. Methods: Prospective Observational Study was conducted in Department of General Surgery, Government Medical College, Solapur from Sep 2016 to Aug 2018 with Sample size of 50 cases. Results: Most common age group affected between 18-29 years, with male preponderance. Most common etiological factor is perianal sepsis following Crypto glandular infection, with pain as most prevalent symptom. Simple fistula is more common, and in complex fistula most prevalent type is high transsphincteric fistula. Most common procedure done is fistulotomy. Most common complication is recurrence. Most number of complications was seen in fistulotomy. Maximum recurrence is seen after fistulotomy. Conclusion: Most common cause is crypto glandular infection, most common feature is pain, Fistulectomy is more efficacious, and complications are maximum with fistulotomy, highest recurrence seen after fistulotomy.