Abstract: Objective To compare the clinical efficacy of incision and thread-drawing technique via incision and thread-drawing technique plus selective suture in the treatment of high anal fistula,and explore the effective and reliable surgical methods for high anal fistula. Methods Total 60 patients with high complex anal fistula were randomly assigned into two groups by number table method.The observation group(n=30) received the incision and thread-drawing technique plus selective suture,while the control group(n=30) received incision and thread-drawing therapy.The healing time,curative rate,anal function score and incidence of complications were compared between the two groups. Results The healing time of the observation group was(22±4) d,of the control group was (24±5) d,the difference was statistically significant(t=3.240,P<0.01).The follow up of six months showed that the curative rate in the observation group was 96.7%,and in the control group was 86.7%,the difference was statistical significance(χ²=3.857,P<0.05).The postoperative anal function score in the observation group was 4.8±1.2,and in the control group was 6.8±1.3,and difference was statistically significant(t=2.671,P<0.01).The follow up of six months showed that there were 4 recurrence cases in the control group and 0 in the observation group,and there was no anal incontinence in both groups. Conclusion Both incision and thread-drawing technique via incision and thread-drawing technique plus selective suture are effective in the treatment of high anal fistula.The incision and thread-drawing technique plus selective suture shows more advantage in the healing time,curative rate and postoperative anal function as compared with incision and thread-drawing technique,which is a better method for high anal fistula.