The application of imaging techniques in the diagnostic work-up of perianal fistulas is fundamental for an adequate description of the pathological lesion with an exact course of the fistular canal, together with its external and internal orifice which, that together with determined concomitant pathologies enables a right choice of a proper therapeutical method that most often involves a surgical intervention. The effectiveness of the treatment is in each case connected mainly with a minimised risk of recurrences and faecal incontinence in postoperative patients. The rate of these complications correlates primarily with unavailable comprehensive and precise imaging diagnostic tools and with different rates of precision of every radiological method. Our work summarises the currently available data on that subject