Introduction: Anorectal disorders including fissure and haemorrhoids are among the most common afflictions of this region which negatively impact the ‘quality of life’ of the patient and incur a massive financial burden on both the patient. Most of the patients hesitate to seek medical care unless the symptoms become too bothersome. The present study was conducted in our proctology unit to compare the outcome of Manual anal dilatation and lateral internal sphincterotomy in the management of fissure in ano. Materials & Methods: The present study was conducted in the Department of General Surgery, Kamalnayan Bajaj hospital, Aurangabad from September 2020 to August 2021 on total of 110 patients admitted for evaluation of Fissure in ano. Patients were randomized in two groups; group A was treated with Manual anal dilatation and group B was treated with lateral internal sphincterotomy under general anesthesia. Results: In our present study 92 % of cases showed posterior location of fissure. One fissure in ano was seen in 108 (97%) and Sentinel piles were seen in 48 (43%) cases. While spasm was present in 110 (99%) study cases. There was a significant difference between the MAD and LIS group for postoperative pain VAS score at 06 hours (P < 0.0001). We have done monthly follow-up assessment of all patients up to 3 months for detecting complications and development of recurrence. Conclusion: It can be concluded that that there was no significant difference in post operative pain between MAD group compared to LIS group. Both MAD and LIS provide early pain relief and high ulcer healing rate and both the procedures are equally effective under experienced hands.