Background: Surgery is the treatment of choice for perianal fistulas aiming to avoid recurrence and preserve anal sphincter function. Successful surgical management requires accurate preoperative assessment of the course of primary fistulous track and the site of any secondary extension or abscesses. Imaging played limited role in the past when conventional fistulography was used, which has low diagnostic accuracy (~16%). Perineal/endo-anal ultrasonography is the first imaging technique that provides anatomical details of anal canal, and can identify primary fistulous tracts and internal openings with good accuracy. However, the limited field of view is an inherent limitation, discounting its value to evaluate secondary tracts or supralevator extensions. With the advent of MR fistulography, imaging now plays a crucial role, providing detailed anatomic descriptions of the fistula along with its relationship with anal sphincter complex. Materials and Methods: Single-centre, descriptive study was carried out in 96 patients who had clinically diagnosed perianal fistula, using MR fistulography and ultrasonography, were followed up and correlated with surgical findings Results: Out of the total 96 patients, 78 were males and 18 were females. Majority of patients (34) belonged to 30-40 years age group (35.4%). Maximum patients were showing inter-sphincteric type (41.6%) according to Parks classification, and grade 1 (31.2%) as per St. James University Hospital classification. For secondary track assessment sensitivity, specificity, accuracy of MRI and USG were 94%, 100%, 98% and 59%, 100%, 85% respectively. For detecting abscesses, sensitivity, specificity, accuracy of MRI and USG were 100%, 100%, 100% and 67%, 100%, 96% respectively. In localisation of internal opening, sensitivity, specificity, accuracy of MRI and USG were 87%, 100%, 89.5% and 90%, 100%, 92% respectively.