Imperforate anus, common name representing more wide spectrum of anorectal malformation of the newborn is one of the major congenital lesions in pediatric surgery. Since the establishment of pediatric surgery in Seoul National University (1978), more than 500 cases of anorectal anomalies were treated until 1990. To evaluate the life after corrective treatment, defecation patterns were studied using clinical Kelly scores in 90 high type imperforate anus who were repaired during 1978-1985, period. These 90 patients were operated by the author, using only two surgical repair methods (26 Rehbein, 64 Pena). Not only the continence scores but also other aspect of social adaptation as well as index of quality of life were compared to control group. Although precise anatomical repair under direct view (Pena) will give better defecation pattern compared to blind type of abdomino-perineal repair, their long term adaptation is not significantly superior. This study showed the function is not always net result of anatomic repair. Thus, the importance of initial corrective operation is again emphasized.