Background: Acquired anorectal fistulas are a severe cause for parental concerns, and they pose considerable challenges in their management. Aim: The aim of this study is to document the pattern of presentation and the management outcome for the cases of acquired anorectal fistula in children seen in our centre. Method: A retrospective review of the thirteen (13) case notes of the patients with acquired anorectal fistulas managed from 2008-2011 was done. The information retrieved included; the age at presentation, sex, aetiology of the fistula, site of the fistula, the duration of the fistula to the presentation, weight loss, and other associated medical conditions, history of a developmental milestone, type of intervention, the outcome of management, HIV status of patients and parents. Results: There were two males and eleven females; eight of whom were HIV positive. Five fistulas were due to each to faecal impaction, birth trauma, trauma from rectal enema procedure, iatrogenic following posterior sagittal ano-rectoplasty (PSARP) and sexual abuse respectively. Conclusion: The fistula healing outcome for acquired anorectal fistula in HIV positive cases was weak compared to the trauma-related groups.