Fistula-in-ano is an abnormal connection between the anal canal and the skin around the anus. It is often the result of a previous or current perianal abscess. The fistula usually originates from infected anal crypts internally and tracks to the perianal skin externally. The majority of the fistulas are cryptoglandular in origin, but Crohn’s disease, malignancy, radiation, trauma, or unusual infections may also produce fistulas. Diagnosis is usually made by physical examination of the perianal region and sometimes aided by procedures such as a fistulogram, proctoscopy, or sigmoidoscopy. An opening of the fistula may be observed, and the perianal region may be tender and erythematous. An induration may be felt, and malodorous discharge may be seen coming out of the fistula. Imaging studies such as a CT scan or MRI are only indicated for deep and complex anal fistulas. Fistulas are classified by their relationship to parts of the anal sphincter complex and are divided into intersphincteric, transsphincteric, suprasphincteric, and extrasphincteric. These classifications help determine treatment decisions and operative planning. Definitive treatment aims to prevent both recurrence and sphincteric injury, and surgery is almost always necessary to cure an anal fistula. An intersphincteric fistula is treated by unroofing or removing the fistulous tract. A transsphincteric or suprasphincteric fistula is treated by placing a drain through the fistula. An extrasphincteric fistula is treated based on anatomy and etiology. We present the case of an 18-year-old male diagnosed with a fistula-in-ano. Fistulectomy was performed by threading the tract and excising it to prevent a recurrence.