Background and Objective: Anorectal malformation is a complex spectrum of anomalies. There are 3 types of anoractal malformation high, intermediate and low. The distinction can usually be made on the basis of clinical data regarding the presence or absence of a visible perineal opening or passage of meconium through the vagina or urethra This study was conducted to assess usefulness of Transperineal ultrasonography (TPU) as an a non–invasive imaging technique in detection of the type of anomaly, presence and location of fistula.

Results: The findings of transperineal ultrasonography (TPU) were correlated with gold standard surgery (Perineal anoplasty/PSARP).

The sensitivity, specificity, PPV, NPV and diagnostic accuracy of TPU was 87.5%, 100%, 100%, 77.77% and 91.307% respectively in detection of fistula in ARM.

Conclusion: Anorectal malformations are complex spectrum of anomalies predominantly seen in male infants (82.35%) with male to female ratio of 4.6:1.Transperineal ultrasonography (TPU) is a valid and an accurate non–invasive imaging technique in detection of the type of anomaly, presence and location of fistula.