Objective: To study the dynamic rectal cavity ultrasound observation of wound healing after anal fistula, in order to provide information for clinical diagnosis and treatment. Methods: The clinical data of 200 anal fistula patients who underwent surgical treatment in our hospital from October 2014 to December 2018 were retrospectively divided into 80 cases in the control group and 120 cases in the experimental group according to whether postoperative intrarectal ultrasound was used. The patients in the experimental group carried out intrarectal ultrasound examination before and after the operation, and dynamically observed the wound healing effect of the patients. The observation results provided further reference for clinical guidance; the patients in the control group did not carry out intrarectal ultrasound examination after surgery, according to the clinician’s Experience determines whether further processing is required. Results: In the experimental group, the complete detection rate of postoperative fistula internal treatment and the total detection rate of the fistula supervisor were higher than those in the control group. The rate of pseudohealing and branch/pus cavity residual detection also increased, the difference was statistically significant (P<0.05); compared with (9.6±1.2) d of the control group, the wound healing time of the experimental group was shortened to (6.8±2.0) d, the difference was statistically significant (P<0.05); the experimental group of patients The incidence of delayed healing, scar infection, and recurrence of anal fistula was lower than that of the control group, and the difference was statistically significant (P<0.05). Conclusion: The dynamic observation of wound healing after anal fistula through intrarectal ultrasound and analysis of ultrasound imaging can provide guidance for the diagnosis and treatment plan in the late clinical period, reduce the risk of recurrence of anal fistula after operation, and improve the quality of life of patients.