Objective:To observe the clinical efficacy of horseshoe-shaped perianal abscess treatment by the way of sphincter approach and tunnel thread-drawing therapy. MethodsA total of 78 hospitalized patients of horseshoe-shaped perianal abscess were divided into treatment group and control group randomly, 39 cases in each group. The treatment group used the way of inter sphincter approach and tunnel thread-drawing therapy while the control group used multi-incision drainage. The clinical effect was observed, and the wound exudation, bleeding, anal pain and fever of the two groups on the 1st, 7th, 10th and 14th day after operation were compared; and those patients were followed for half a year with the recurrence rate, fistula rate and anal fistula type of the two groups being observed and compared.  Results:①The number of cured, effective and non-cured cases in the treatment group was 21,17 and 1 respectively, while that in the control group was 12,19 and 8 respectively. The clinical effect of the treatment group was better than that of the control group (P<0.05). ② The recurrence rate of the treatment group and the control group was 2.6% and 20.5% respectively, the fistula rate was 46.2% and 69.2% respectively, and the proportion of complex anal fistula was 33.3% and 70.4% respectively. The recurrence rate, fistula rate and complex anal fistula rate of the treatment group were lower than those of the control group (P<0.05). ③ On the 10th and 14th day after operation, cases with wound exudation in the treatment group were fewer than those in the control group (P<0.05); on the 7th, 10th and 14th day after operation, cases with anal pain in the treatment group were fewer than those in the control group (P<0.05); on the 1st day after operation, the fever degree in the treatment group was lower than that in the control group (P<0.05).  Conclusion:Compared with the traditional multi-incision drainage, the treatment of horseshoe-shaped perianal abscess by the way of sphincter approach combined with tunnel thread-drawing therapy is more conducive to postoperative recovery, and can effectively reduce the recurrence rate and the formation of postoperative anal fistula, especially the occurrence of complex anal fistula.