This case report highlights the efficacy of traditional Korean medicine in treating chronic levator ani syndrome.</br>A 47-year-old male suffered from chronic anorectal pain for 14 years. Over the last 5 months, the severity and frequency of the pain increased, and he was unresponsive to Western medicine and acupuncture outside Korea.</br>The patient reported moderate anorectal pain from early morning until midday, affecting daily efficiency and concentration. The pain was triggered by defecation and alleviated by lying down. He was diagnosed with levator ani syndrome related to “cold symptoms of the liver and kidney - Yin”, for which modified <i>Nangan-jeon</i> was prescribed. Indirect moxibustion (CV4, Ki1), <i>Aconitum ciliare</i> Decaisne pharmacopuncture (GV1, BL33), and acupuncture (HT7, ST36, SP6, LR3, LI4) were also administered weekly. After 8 weeks, the anorectal pain decreased by 2 points on a numeric rating scale, leading to patient satisfaction and return to his home country.