Fissure-in-ano is a common anorectal condition characterized by severe pain and bleeding during defecation. Conventional treatments such as topical anesthetics, nitroglycerin ointment, and surgical interventions are effective but may be associated with recurrence, side effects, or complications. In recent years, natural remedies have gained interest as safer and cost-effective alternatives. Nimba Tailam(Azadirachta indica), known for its anti-inflammatory, antimicrobial, wound-healing, and analgesic properties, has been traditionally used in various skin and mucosal conditions. This single case study evaluates the effectiveness of topical application of Nimba Tailam in the management of a patient with Acute fissure-in-ano. Following regular application, the patient reported marked reduction in pain, bleeding, and discomfort, along with progressive healing of the fissure without any adverse effects. The findings suggest that Nimba Tailam may serve as a simple, affordable, and well-tolerated therapeutic option in fissure-in-ano management.