Painful conditions of the anal and perianal region are commonly encountered problem and relatively simple to cure. The aim of this study is to enumerate the causes,age incidence,sex ratio and associated factors in patients presenting with pain in the peri–anal region. A prospective study was conducted in GMKMCH Salem from September 2010 to August 2012,and the most common cause of pain is fissure in–ano,with equal incidence in men and women and simple surgery can cure it.