Congenital anorectal deformities present a therapeutic challenge to the paediatric surgeon. The anomalies encountered range in complexity from the most simple to the most intricate. It is for this reason that three clear phases in management are defined and applied in every instance, i.e. absolute clarification of the anatomy of the defect, its appropriate operative correction, and, finally, a protracted postoperative period of care during which time voluntary stool control is acquired. Anal continence is the ultimate functional objective. The meticulous treatment required by the unfortunate baby born with this correctable abnormality is emphasized.