Abstract:Introduction: One in 5,000 live births is found to have anorectal malformations with a female preponderance. These patients are managed during the first year of their life with advanced health care facilities. Still a few cases present in adult life. Case Report: One such case of a 24 year old female is reported here who presented with chronic constipation. Transverse colostomy was done at birth, soon after diagnosing anorectal malformation. The stoma underwent spontaneous closure and she continued to pass faeces through anovestibular fistula. Anterior sagittal anorectoplasty was performed and a continent neo-anus was created. Conclusion: Careful neonatal examination shall diagnose all anorectal malformations at birth. Illiteracy, lack of neonatal health care, inadequate medical facilities are some of the reasons for the delayed diagnosis and persistence of this condition till adulthood. Most pediatric surgeons consider posterior sagittal anorectoplasty as the procedure of choice in treating anorectal malformation.