There is an increase in specialisation within general surgery and now even within its sub specialties. Colorectal surgery is probably the largest of the subspecialties of general surgery, and one of the areas where trainees and consultant general /colorectal surgeons are least confident is in their understanding of the anatomy, physiological pathology and management of the anal canal and pelvis. Currently available there are books on the market centred around the general management of colorectal disease, but the time is now right for a definitive text on the anal canal and pelvis specifically.