Fissure in ANO is one of the most common ANO rectal problems. Anal fissure is a linear or oval shaped tear in the anal canal starting just below the dentate line extending to the anal verge. Aims: The present study aims at determining the clinical presentation, site, symptomatic relief, healing rate and best treatment modality of fissure in ANO. Materials and Methods: This study is observational study in patients with ANO rectal problems who were randomly selected in this study. The diagnosis

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... s made on the basis of ANO rectal examination which included inspection, digital rectal examination, and proctoscopic examination. Results: Our study found out that out of the 50 patients with ANO rectal problems.50 patients (100%) were having anal fissures. Out of them, 30 were males and 20 were females, majority were 18-30 years age group. Pain during defecation, bleeding and constipation were reported as the common clinical symptoms. In this study we compare clinical presentation, site, symptomatic relief, healing rate of 0.2% GTN treatment, Manual anal dilatation and lateral internal sphincterotomy in the treatment of fissure in ANO. 20 patients were underwent lateral internal sphincterotomy and 20 underwent manual anal dilatation with 10 patients treated with 0.2% GTN ointment. We studies outcome of these each modality and compared them with different studies. Lateral internal sphincterotomy remains the gold standard for definitive management of anal fissure. Conclusion: Lateral internal sphincterotomy is one of the standard and best treatment modality for fissure in ANO.