Objective To evaluate the diagnostic value of per perineal high -frequency ultrasound and/or per rectal endoscopic ultrasound in anorectal diseases. Methods 54 patients suffered from anorectul diseases, including 22 patients with anal fistula, 14 patients with perianal abscess, 12 patients with rectal cancer, and 6 patients with perianorectal inflammation, were performed with per perineal high-frequency ultrasound and/or per rectal endoscopic ultrasound examination. The diagnostic results were confirmed by clinical diagnosis, including operative and pathological detection. Results Except for the misdiagnosis of 4 cases of orifice location and 1 case of rectal cancer, all the other cases were correctly diagnosed. Conclusion Combined application of per perineal high-frequency ultrasound and per rectal endoscopic ultrasound examination has great practical value for ascertaining the trend and internal orifice location of anal fistula, location of perianul abscess, the infiltration depth of rectal cancer, and lymph node metastases.