Anal imperforation or anorectal malformations (ARM) are malformations concerning the rectum. ARMs are a spectrum of various birth defects that vary from fairly minor lesions to complex anomalies. There are three types: the high form, the intermediate form and the low form. They are more and more frequent in our undeveloping countries where resources are limited. Their management is expensive and complex, especially the high form. We report a case of anal imperforation with rectovaginal communication which was referred to us from another region of Mali more than 1000 KM, for care.