Objective We report our experience with a transvaginal approach with overlapping AS repair. The aim of this study was to evaluate long term functional outcomes. Design Retrospective Cohort study. Setting and Population Women who had undergone AS surgery for anal incontinence from July 2005 to July 2020. were included. The patients included attended the Mercy Hospital Perineal clinic a multidisciplinary team of urogynecologists and colorectal surgeons. Private patients from the surgeons in Perineal clinic were also included. Methods Overall 107 women were included in the study with a median follow up of 57.5 months. Main Outcome Measure We analysed outcomes by comparing patients St marks score difference before and after surgery. Meaningful clinical difference (MID) was set at 5 points as per previous validation studies, complications and patient demographics were recorded along with a question if they would recommend this treatment to a friend. Results An improvement exceeding the minimal clinical difference (MID) was seen in 69.3% of women. With a marked improvement in 46.5% of patients. Furthermore 70% of our patients would recommend the procedure to a friend, if they were in a similar situation. Wound infection or perineal breakdown occurred in 45% of women but did not significantly impact on outcomes. Conclusion Transvaginal AS repair is associated with significant improvements in patients’ St. Marks score. Our data shows that the long-term success rate of transvaginal AS repair may be better than previously reported in the literature using a transvaginal approach. Funding This study received no funding or sponsorship