Perianal fistula is an abnormal communication between the epithelial surface of the anal canal and skin as a hollow fistulous tract which is lined by granulation tissue. Fistula-in-ano has a tendency to chronicity and very much affect quality of life of an individual. Imaging of perianal fistulas is an important part of management as magnetic resonance imaging provides accurate information on the anatomy of the anal canal, the anal sphincter complex and relationship of the fistula to the structures of pelvic floor. Magnetic Resonance Imaging can accurately demonstrate inflammatory changes, secondary tracts, ramifications and abscesses which can be missed on conventional fistulography. MRI has been considered the gold standard technique for perianal fistula assessment because it provides the clinician with an accurate roadmap to select the best surgical approach. The aim of the article is to review the role of magnetic resonance imaging in preoperative assessment of perianal fistula, tracing its relationship, diagnosis and classification of perianal fistulae.