Anorectal malformation is a birth defect involving defects of the distal anus and rectum that occurs during fetal development between 4-16 weeks gestation. It occurs when the rectum fails to properly connect to the anus. Major abnormalities have an incidence of 1 in 5,000 live births and more commonly affect boys than girls. Diagnosis is made at birth by the lack of an anal opening. Investigations like invertograms and ultrasounds are done to determine the distance between the rectum and anus. Surgical procedures vary depending on the type and severity of the defect. Post-operative nursing care focuses on nasogastric suction, IV fluids, monitoring vitals, and starting feeds when bowel function returns