PURPOSE: Sphincter fixation after fistulectomy for low intersphincteric anal fistulas was performed for prevention of sphincter insufficiency and anus transformation. Here, the operative results and the influence on anal function after operation are evaluated. PATIENTS: Between January 2007 and July 2010, 265 cases were operated for low intersphincteric anal fistulas. After fistulectomy, the sphincter muscle edges are detached from tissues just under the skin and fixed to the underlying tissues. Eighty-two patients had undergone anal manometry examination preoperatively, and at 1 and 6 months after surgery. RESULTS: Recurrence occurred in 6 cases (2.3%). In 5 patients, further surgery was necessary. Two patients underwent lay open, two underwent repeat sphincter fixation, and one underwent seton technique. After 1 month, MRP values were significantly lower than baseline preoperative values, but had slightly increased after 6 months. After surgery, MSP values were not significantly different from preoperative levels. Six months postoperatively, minor symptoms of anal incontinence (soiling, flatus) and anus transformation were not present. CONCLUSIONS: Sphincter fixation after fistulectomy for low intersphincteric anal fistulas had good results and prevented deformations. Anal squeeze pressures were better preserved and this may have improved anal continence.