INTRODUCTION: A 37-year-old woman developed abdominal pain, and diarrhea six weeks after a total hysterectomy with bilateral Salpingo-Oophorectomy was performed for a benign indication. A computer tomography (CT) scan of the abdomen and pelvis with intravenous contrast showed a perirectal abscess, measuring 6.2 × 5.7 × 6.1cm Figure 1. The perirectal abscess was drained transrectally by placement of a cautery enhanced 10 × 10 mm lumen opposing metal (LAM) stent, creating a fistula between the abscess and the rectum. CASE DESCRIPTION/METHODS: Using a transrectal approach, the perirectal abscess was imaged by endoscopic ultrasound (EUS). Under doppler ultrasound and fluoroscopic guidance, the abscess was punctured with a 19gauge fine needle aspiration (FNA) needle. A 450cm x 0.025-inch wire was passed through the needle and allowed to coil multiple times in the abscess for stability. The LAM stent was advanced over the wire 4 cm into the abscess and deployed in position Figure 2. There were no complications. Three weeks after the endoscopic placement of the LAM stent, a CT scan showed complete resolution of the perirectal abscess Figure 3. The same week, the stent was removed endoscopically without complications. DISCUSSION: This case demonstrates that LAM stents can be safely use for drainage of perirectal abscesses and non-malignant, wall mature perirectal fluid collections. The dumbbell shape design of the stent keeps the fistula tract intact preventing leaks and decreasing the incidence of stent migration and perforations. To safely deploy the distal end of the stent inside the fluid collection, the stent's catheter needs to be advanced 4 cm into the collection before deployment. If this is not accomplished the distal end of the stent may be deployed outside of the fluid collection causing a perforation. If a stable position of the EUS scope is secured there is no need to puncture the fluid collection with a 19-gauge FNA needle, nor to pass the wire into the cavity, because it can be directly accessed with the cautery enhanced tip of the stent's catheter affording a much shorter procedure time.Cases of bleeding have been reported after the collection has been drained and the cavity has collapsed; it is therefore suggested that the optimal time for stent removal is three weeks after stent placement once the fistula tract has been formed and resolution of the collection is confirmed by cross sectional imaging.