Background: Fistula-in-ano is common surgical condition yet difficult to treat without problems. Now a days management remains dependent on two conventional surgical options (open fistulectomy/ fistulotomy and fistulectomy with primary closure), mostly depends on preference of surgeon, and their experience. Methods: This was a prospective, randomized study conducted to compare fistulotomy with fistulectomy in the management of patients with fistula-in-ano attending surgicalout-patient department. Fifty patients were recruited a randomized into two groups each containing 25 patients in both the groups, group I was managed by fistula tomy and group II was managed by fistulectomy. The outcomes of the study include type of fistula, post-surgery hospital stay, wound healing time, postoperative pain, and postoperative complications early as well late. Results: Out of the 50 patients, 09 (18%) were female and 41 (82%) were male with a mean age of 36.2 ± 12.36 years. The mean post-surgical hospital stays in the 1stgroup was14.44 ± 8.2 days and in the 2nd, group was 6.59 ± 1.83 days (p < 0.001). Mean Visual Analog Scale score(VAS) was higher in fistulotomy when compared with the fistulectomy immediately after surgery(p < 0.001). Postoperative complications were found to be same in fistulotomy patients compared with patients who underwent fistulectomy. Conclusion:From this study we can conclude fistulectomy with primary closure is ideal for low anal fistula. This saves number of days required for wound healing, hospital stay and results in less expenditure for patients, saves the number of working days lost. This lessens the work load on doctor and hospital staffs.