<p>Anal stenosis (AS) is a condition characterized by the narrowing of the anal canal, commonly resulting from fibrotic changes after hemorrhoidectomy. This leads to difficult and painful defecation, reduced anal canal elasticity, and may impair continence. Moderate to severe AS often requires surgical intervention when conservative treatments fail. This study aims to assess the outcomes and efficacy of calibrated rhomboid-flap anoplasty in patients with moderate to severe anal stenosis following hemorrhoidectomy. Thirteen patients (8 males, 5 females; mean age 51.7 ± 4.2 years) with moderate (61.5%) and severe (38.5%) anal stenosis refractory to dilation therapy underwent calibrated rhomboid-flap anoplasty between March 2021 and February 2025. Anal canal diameters were measured preoperatively, intraoperatively, and 12 months postoperatively using calibrated dilators. Functional outcomes were evaluated using the Cleveland Clinic Incontinence Score (CCIS) and Modified Longo Score for Obstructed Defecation Syndrome (ODS). Postoperative complications, length of hospital stay, and time to return to daily activities were recorded. The mean preoperative anal canal diameter of 10.6 ± 2.7 mm significantly increased to 24.6 ± 2.2 mm postoperatively (p = 0.001). Both CCIS and Modified Longo Scores improved significantly at one year (CCIS: 2 ± 1.6 to 0.7 ± 0.8, p = 0.006; Longo: 18.3 ± 2.9 to 3.3 ± 1.4, p = 0.001), indicating better continence and reduced obstructed defecation symptoms. No major complications or wound dehiscence occurred; superficial infections were managed conservatively in three patients. The average hospital stay was one day, with a mean return to normal activities in 7.6 ± 0.6 days. Standardized and calibrated rhomboid-flap anoplasty appears to be a safe and effective treatment option for anal stenosis developing after hemorrhoidectomy, providing favorable anatomical and functional outcomes with acceptable morbidity.</p>