The surgeries of anal fistula have a disagreeable reputation for subsequent recurrences fecal soiling, imperfect controls of flatus, difficulties of wound healing, more hospitalization etc. Man always strives for the best that is why the advancements and research has become a continuous process. Today, not only medical fraternity but common man also wants to verify the ancient claims which are time tested since centuries, on present day available scientific parameters. Kshara and Ksharasutra will definitely play a key role in the development of surgical procedure in ano-rectal diseases. Ksharasutra is a unique and an established procedure for difficult surgical diseases. It has brought revolution in the Indian system of surgery. Ksharasutra ligation therapy in the management of Fistula in ano has proved boon for the humanity. It effectively substitutes the modern surgical procedure.