Perianal abscess is the most common disease in anal, almost in man. It is caused by infections of anal glands, and the inflammations spread to the perianal gap, eventually abscess formation in perianal. There are a number of perianal abscess diseases caused by systemic diseases, such as inflammatory bowel disease, cancer and hematological system diseases. Whatever the perianal abscess arises from the infection of anal glands or the systemic diseases, in common, the strategy of therapy is incision and drainage. But after incision and drainage, the formation of fistula rate is higher. Abscess often spread widely in perianal, so improper surgical treatment may cause potentially residual cavity, leading to recurrent abscess and fistula formation. according to the characteristics of the anatomy around the anus, The author takes ″three cavity clearance″ to drainage the perianal abscess completely, and achieves certain results. The Commentary will discuss the perianal abscess surgical options.