Anal fissures are painful tears in the lining of the anus, often treatable with medication and lifestyle changes. But when do you know it’s time for surgery? This guide explores the signs and conditions that make surgical intervention necessary. From chronic fissures that don’t heal with conservative treatment to complications like spasms and recurrent pain, learn the key indicators and surgical options such as lateral internal sphincterotomy. We also discuss post-operative recovery and long-term outcomes. Whether you’re suffering from persistent discomfort or considering your next step, this article offers reliable insight into when surgery is truly needed.