The perineum includes all structures below the pelvic diaphragm and occupies the pelvic outlet. The ischio-rectal fossa is a space on each side of the anal canal bounded above by the pelvic diaphragm and below by the ischium bone. It contains fat which acts as a cushion for the rectum and anal canal during defecation. The fossa has several recesses and is divided by fascia into supra-tegmental, ischio-rectal, and perianal spaces containing fat, vessels, and nerves. Diseases that can affect the fossa include hernias, abscesses, fistulas, and infections due to its anatomical structure