Background: Anorectal malformations (ARM) are birth defects in which the anus and rectum dont develop properly ranging from simple to complex entities which require complicated surgical intervention. Despite treatment, it causes considerable morbidity and mortality. Incidence is about 1 in 2,000 to 5,000 live births worldwide. In developing countries such as Tanzania, the management of ARMs poses a diagnostic and therapeutic challenge The most common challenges are Late presentation, limited access to trained pediatric surgeons, and inadequate facilities for diagnosis of associated congenital anomalies Aim: To determine the prevalence and treatment outcome of anorectal malformation at MMH in five years from 2018 to 2022. Objectives: This was accomplished with the following specific objectives namely, to describe the Age and sex distribution of the patient with anal rectal malformations admitted at Mnazi Mmoja Hospital, to determine the incidence of ARMs in patients admitted at MMH in the surgical ward, to identify the common types of ARMs, to find out the type of surgery performed for ARMs treatment, to evaluate complications associated with surgery in a patient with ARM Methodology: A hospital-based retrospective, descriptive cross sectional study. Information was recorded in a structured questionnaire and then entered into Statistical Package for Social Science (SPSS) Software version 22.0 for analysis Tables and chat were used to present the variable outcome as presented below Results: The sex distribution male to female ratio was nearly 1:1, number of cases recorded in 2018 was 8(9.9%) increasing to 33(40.7%) in 2022. Geographically distribution of cases was Pemba 18(22.2%), South Unguja 9 (11.1%), North Unguja 14 (17.3%) and Urban West 40 (49.9%) patient complaints were the absence of anal opening 68 (84%) followed the passage of stool through urethra/ Vagina /Perineum 8(9.9%). According to the Krickenbeck classification, the majority of patients 73(90.1%) had major clinical type ARMs and 8(9.9%) had minor clinical type ARMs. Surgical management 3 stage procedure (53(65.4%)- complete all stages and 17(21.0%) not yet all stage) and 1 stage procedure 11(13.6%) out of all managed patients 14 develop postoperative complication diving complication rate of 17.2%, the remaining 67(82.7%) present no complication, colostomy prolapse 5 (6.2%) occurred mostly. Living status 73(90.1%) overall survival rate and mortality rate of 8(9.9%) Most major type ARMs 45(55.6%) were hospitalized in less than 10 days but no case of Minor was hospitalized more than 15 days. Conclusion: In Zanzibar, as in other parts of the world ARMs are common surgical problems causing considerable morbidity and mortality. Out of all pediatric gastrointestinal surgeries ARM accounts for 35%. Modern surgical approach single stage approach in the management of ARM will improve patient outcome

The authors have declared no competing interest.

This study did not receive any funding

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