Introduction : Recto-urethral fistula is a rare complication of pelvic surgery, trauma, or inflammation. The many techniques for repairing these fistulas vary in their success rates. We describe the use of vascularised tunica vaginalis flap interposition in the repair of a recto-urethral fistula. Materials and Methods : Three children who had developed rectourethral fistula following surgery for anorectal anomaly/Hirschsprungs disease underwent repair through the perineal approach and interposition of vascularised tunica vaginalis flap in between the rectum and the urethra. Results : Three patients, all males aged 6 to 14 years old, presented with passage of urine per rectum following surgery. Following repair of the recto-urethral fistula, there was no recurrence of fistula in the follow-up period ranging from 1 to 6 years. Conclusions : Vascularised tunica vaginalis flap interposition is a straight-forward technique that can result in successful fistula repair.