We retrospectively reviewed the charts of 55 patients with ischiorectal abscesses treated from 1980 to 1983 at the Cleveland Clinic Foundation. The patients were treated by placement of a 10F to 16F soft latex mushroom catheter into the abscess cavity under local anesthesia as an office procedure. The end of the catheter was shortened to leave 2 to 3 cm exiting the skin, and a bandage was applied. No sutures or irrigations were used, and the drains were removed an average of 12 days after placement. Antibiotics were not given. The patients ranged in age from 17 to 76 years (mean, 40 years) and 36% were female. Four patients had diabetes, and eight had a history of inflammatory bowel disease. Nine patients had been treated previously for anorectal abscesses. There were no complications. Adequate follow-up was obtainable in 31 patients (ten to 63 months; mean, 30 months). Eight of them (26%) were subsequently treated for fistulas found after resolution of the abscess, and an additional eight (26%) had a second abscess form during the follow-up period. The average time to this recurrence was 20 months. Catheter drainage of ischiorectal abscess in selected cases resulted in healing with low morbidity and significant cost savings.