Background: Perianal fistula is an abnormal connection between the epithelialized lining surface of anal canal and the perianal skin. The ideal treatment for an anal fistula should be associated with low recurrence rates, no incontinence and good quality of life. The aim of this study is to evaluate the ligation of the intersphinteric fistula tract (LIFT) technique as a method in treatment of perianal transsphincteric fistula. Patient and method: This prospective study was done in zagazig university, general surgery department from May 2015 to October 2016 and follow up ranged from 6 to 18 months with a mean follow up of 12 months, included (28) patients suffered from perianal transsphincteric fistula. They underwent LIFT technique. Patients with perianal fistulas from other causes like individuals with Crohn’s disease, tuberculosis, anal cancer and who had recurrent fistulas or active perianal sepsis were excluded. Patients with intersphincteric, suprasphincteric and extrasphincteric perianal fistulas were also excluded. Followup included postoperative infection, healing time, recurrence and fecal continence according to St. Mark score were evaluated. Result: local infection occurred in six patient (21.4%), treated by drainage and antibiotic, the healing time varied from 5 to 7 weeks after the procedure. Twenty two patients (78.6%) had complete healing and resolution of the fistula, while six patients (21.4%) had a recurrence in the form of an intersphincteric fistula, subsequently operated by two stage operation (fistulectomy, seton) with complete resolution. One case (3.6%) developed incontinence for flatus improved after 6 months. Conclusion: LIFT is good and safe technique for treatment of perianal transsphincteric fistula Keywords: LIFT, Anal sphincter, Fecal incontinence.