The authors performed transvaginal repair of rectovaginal fistual (RVF) with bulbocavernosus fat pad by incising left side of the labia majora and retained scar tissues which were formed after three months for one patient. Repair of the RVF was successful and the patient had normal diet and defecation at a week after surgery. Previous gynecological surgery performed on the patient resulted in RVF accompanied by weak rectal tissues. Retaining the tissues and scars surrounding to the fistula and filling the fistula with bulbocavernosus fat pad tissue increased rectal wall thickness and facilitated healing. The efficacy of this surgical technique will need further studies with larger patient cohorts to establish a clear success rate.