Background: Anal canal and perianal tissues are frequently inflamed, and this is represented by perianal fistulas. Idiopathic inflammation of the cryptogenic glands in the anal mucosa is the cause of the majority of these fistulas. This study evaluated the role of diffusion-weighted imaging in patients with perianal fistulae. Materials &Methods: 60 patients of perianal fistulaeof both genders underwent pelvic MRI using a phased-array surface coil while supine on the Philips Ingenia 1.5 Tesla machine. Using T1W, T2W, DWI, VISTA, and fat-suppressed postcontrast T1W sequences, the perianal fistula was assessed. Results: Out of 60 patients, 32 were males and 28 were females. Out of 60 patients, 35 were active and 25 inactive fistulae. Secondary ramification of the primary fistula tract was seen in ischioanal space/ ischiorectal fossa in 31, intersphincteric space in 18 and supralevator space in 11 cases. St James classification grade 1 was seen in 24, grade 2 in 10, grade 3 in 8, grade 4 in 11 and grade 5 in 7 patients. The difference was significant (P< 0.05).MRI sequence DWI had visibility score 2 was seen in 32 in active and 14 inactive, score 1 seen in 3 active and 11 inactive. T2W score 2 in 22 active, score 1 in 8 and score 0 in 5 active and score 2 in 15 inactive, score 1 in 3 and score 0 in 3 inactive. Combined score 2 in 35 active and 25 inactive. DWI-T2W score 1 was seen in 1 inactive and score 2 in 1 inactive. CEMRI score 2 was seen in 40 active and 23 inactive and score 1 in 2 inactive cases. The difference was significant (P< 0.05). Conclusion: The combined DWI-T2W image evaluation in perianal fistulas showed the best results.