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Abstract Anorectal malformations (ARMs) occur in approximately 1 in 4000 to 5000 live births, with imperforate anus being the most common variant.Traditionally, most patients undergo a series of procedures starting with a descending colostomy, then PSARP with colostomy closure after 3 months. .Our study is a combined study (prospective and retrospective) aimed to compare the long-term functional outcomes (the continence status and quality of life) of LAARP versus PSARP in management of patients with High ano-rectal malformations. The sample initially included 62 male patients with High imperforate anus but 19 patients were lost in the follow up and only 43 patients were included in the study .All the patients included in the study were males.Patients were classified into two groups the first one included 20 patients and were managed by LAARP (group A) while the second one included 23 patients that were managed by PSARP (group B) at the Department of Pediatric Surgery, Cairo University Specialized Pediatric Hospital and Minia Pediatric Surgery Unit. Regarding the degree of continence , Both techniques offer similar outcome .we found that no significant differences between both techniques in the outcome of continence as evidenced in our results . we found that the patients with good fecal continence were cases (30%) in LAARP group and (39.1%) in PSARP group while Patients with severe degree of incontinence were cases (10%) in LAARP group and (17.4%) in PSARP group without significant differences between both groups |