Rectal fistula is a rare complication that may occur during and after radical prostatectomy, regardless of the applied surgical technique. It accounts for about ≤ 1% of surgical complications. Patients who have undergone radical prostatectomy associated with prior pelvic radiotherapy, previous rectal surgery and transurethral re-section of the prostate have an increased risk for incidence of anorectal fistula. This review analyzes recent original studies and reviews. The studies evaluated deal with important prognosis and incidence rates, while studies related to the therapeutic resolution of the problem were excluded. The four different types of surgical techniques (ORP, RPP, LRP and RARP) to remove the prostate were also compared, in order to identify the best method associated with the fewest complications. This study aims to evaluate specific literature in order to understand which surgical technique is associated with the lowest risk of this complication, and the prognostic factors that lead to a higher risk of rectal injuries.