Objective: To summarize the diagnosis and management of postanorectal space abscess. Methods: The clinical data of 93 patients with postanorectal space abscess were retrospectively analyzed. Of the patients, bilateral fenestrated catheter drainage (from both sides of the anococcygeal ligament) with the preservation of anococcygeal ligament plus thread-ligating method was performed in 21 cases of horseshoe abscess, 45 cases of semi-horseshoe abscess, 12 cases of fistulized postanal space abscess, and 9 cases of postanal space abscess; and fenestrated catheter drainage was performed in 6 cases of postrectal space abscess. Results: Clinical recovery was achieved in 89 cases (95.7%). All patients were followed up for 6 to 24 months after surgery, and no recurrence or postoperative complications such as anal stricture or fecal incontinence occurred. Four cases (4.3%) had recurrence of anal fistula after surgery. This was mainly due to failure to find the true internal opening when performing thread-ligating procedure, and too early extraction of the drainage tube, which led to obstructed drainage and finally fistula formation. At a second operation 3 months later, the fistula and anococcygeal ligament of the patients were removed, the granulation tissues were eliminated and the thread-ligating procedure was performed again after confirmation of the internal opening, and the patients were cured. Conclusion: Fenestrated catheter drainage (from both sides of the anococcygeal ligament) combined with selective thread-ligating procedure can maintain the shape and function of the anus, and is an ideal treatment method for postanorectal space abscess.