Anoperineal lesion (APL) occurrence may be a significant event within the evolution of regional enteritis (CD). Management should involve a multidisciplinary approach combining the knowledge of the gastroenterologist, the colorectal surgeon and therefore the radiologist who have appropriate experience during this area. Perianal Crohn's disease is often recurrent, with 35% to 59% of patients relapsing within 2 years. More than 80% of patients require surgery, and as many as 31% require a permanent stoma. The presence of perianal disease is related to a more disabling explanation , with increased extraintestinal manifestations and greater steroid resistance. MRI is suggested for complex secondary lesions, particularly after failure of previous medical and/or surgical treatments. Abscesses and fistulas require specific medico-surgical management where seton drainage, staged operative and sphincter-sparing procedures have a dominant place. Recent therapeutic progress has led to modifications of the minimally invasive management policies practiced in the last decades. Anoperineal tuberculosis may be a rare extrapulmonary sort of the disease that we must learn to acknowledge because it requires specific treatment.