Background: Fistula in ano is a common disease seen in the surgical outpatient department. Many procedures are advocated for the treatment of fistula inano. However, none of the procedures is considered the gold standard. The video-assisted anal fistula treatment (VAAFT) is a new technique which seems to be promising in this field as it is a minimally invasive, sphincter-saving procedure with low morbidity. The aim of our study was to compare the results of the VAAFT with the classic open technique. Methods: The study was conduct on 20 patients who were suffering from fistula in ano ,they were divided into two groups as 10patients in group A were treated with the open techniquewhile the other group B of 10 patients were treated by the VAAFT. The VAAFT procedure involves diagnostic fistuloscopyand visualization of the internal opening, followed byfulguration of the fistulous tract and closure of the internal opening with a stapling device or suture ligation. The video wasconnected to an illuminating source. Results: The study was conducted from July 2016 to July 2017. Fifty patients with fistula in ano were operated on with VAAFT and open technique and were divided into two groups each contain ten patients then they were followed up according to the study protocol. The postoperative bleeding in group A (open technique) were 2patients (10%) while there were no postoperative bleeding in group B (VAAFT), while the postoperative pain in group A were 7 patients (35%) while only one patient (5%) in group B , there were flatus incontinence in 1 patient in group A while there were no incontinence in group B, while the recurrence rate were higher in group B as6 patients (60%) while no recurrence with group A of the open technique. Conclusion: The VAAFT technique is a minimally invasive and safe technique. But there are higher incidence of recurrence in VAAFT in comparison to the traditional open technique. Key Words: Fistula in ano, Video-assisted anal fistula treatment (VAAFT),Fistuloscopy.