Perianal skin tags are defined as soft growths that develop in the perianal region. Perianal skin tags commonly develop in patients with chronic anal fissures or following the healing of anal fissures and thrombosed external hemorrhoids. Perianal skin tags are not contagious and cannot be transmitted through sexual contact. Perianal warts can develop secondary to infection or virus such as human papillomavirus (HPV). Genital warts are considered the most common sexually transmitted disease (STD). This chapter discusses the difference between anal warts and skin tags, their etiology, clinical features and treatment.