Background: Fistula-in-ano (FIA) is one of the most common benign anal conditions in daily surgical practice. Modern management of anal fistula include anal fistula plug, fistula laser closure, adipose-derived stem cells and platelet-rich plasma (PRP )injection. The study was aimed to compare the efficacy of platelet rich plasma injection versus ligating inter-sphincteric fistulous tract in treatment of high transsphincteric peri-anal fistula. Patients and methods: Our study was carried out in General Surgery Department, Zagazig University Hospitals and included 18 patients who were divided in two groups; 9 patients were treated with platelet rich plasma injection after curretage of the fistulous tract and 9 patients were treated with ligation of the intersphincteric fistulous tract with close monitoring and followed up of all the patients of both groups as regards to: operation time, hospital stay, healing time, postoperative incontinence and recurrence. Results: By the end of this study, the results showed no significant difference between the two techniques in relation to healing time ,post operative sappuration , incontinenece and recurrence . However platelet rich plasma was slightly better regarding healing time and incontinence while LIFT was slightly better regarding healing and recurrence . Conclusion:It could be concluded that, both platelet rich plasma and ligation of the inter-sphincteric fistulous techniques are promising procedure with better healing rates and less liability for postoperative recurrence. However, PRP was slightly better regarding healing time and incontinence and LIFT was slightly better regarding the rate of recurrence .