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Rectovaginal fistula is an abnormal communication connecting the rectum and vagina characterized by involuntary leakage of stool and gas from the vagina. Symptoms may include difficulty in defecating, incontinence, foul smelling discharge, and painful intercourse. Its causes are diverse, ranging from obstetrical trauma in childbirth to inflammatory bowel diseases. Diagnosis is made through physical examination, imaging, and laboratory testing. Treatment is tailored to the individual patient and may include repair of the fistula using various methods and medications to manage accompanying symptoms. To ensure successful treatment, it is important to accurately diagnose the underlying cause.