Fistula-in-ano is a long-lasting inflammatory condition where there is a small tubular structure with opening in the Anorectal canal at one end and surface of perineum or perianal skin on the other end. Any opening in perianal area with chronic pus discharge indicates fistulous tract. Prolong sitting(squatting position), unhygienic condition, obesity, constipation, repeated irritation due to hair may increase the risk of occurrence. Historically, surgery has been the primary treatment for this condition; however, surgical intervention often fails to provide a complete cure. Recurrence is common, and in many cases, complications such as fecal incontinence result from damage to the sphincter muscles. In some instances, the treatment may lead to complications that are more severe than the original disease. Chronic infections, including tuberculosis and venereal diseases, are often associated with Bhagandara and can exacerbate the condition. The Ayurvedic texts, particularly Sushruta Samhita and Ashtanga Hridaya, extensively describe various medical, surgical, and para-surgical treatments for this condition. Here a case of fistula in Ano in a 23-year male patient was examined in Shalya OPD and treated with Ksharasutra, considering it as an ideal procedure in treatment of Bhagandara as it cuts and curettes the unhealthy tissue present inside the fistulous tract.