Anal fistula, a challenge for modern surgery, but can be cured with grade ksharsutra in Ayurveda (Indian system of medicine). An anal fistula is a disease for which different methods of treatment have been advocated from time to time, even today when we are talking about robotic surgery, this disease has no satisfactory method of treatment in modern surgery. The latest method of video-assisted anal fistula treatment (VAAFT) is not satisfactory due to the high incidences of recurrence after the surgery. But at Sushruta Anorectal Institute New Delhi; with the help of Graded KsharsutraTM all these patients of complex Anal fistula are being successfully treated without surgery.