A perianal hematoma is a localized collection of blood outside of blood vessels under the skin located around the border of the anus. Perianal hematomas can present over a short period of time and be extremely painful. The main symptom is pain and the swelling around the anus. Pain can range from mild to severe depending on the size of swelling that can be treated through Jalaukavacharana, a para surgical procedure in Ayurveda.Jalaukavacharana i.e. blood- letting by Jalauka is used in a variety of inflammatory conditions especially when Pitta Dosha is vitiated and gets lodged in the blood. Its mode of action depends on the injection of leech saliva into patient's tissues during the process of bloodsucking. Leech saliva contains bioactive constituents which possess anti-inflammatory, analgesic, thrombolytic, vasodilator, anti-coagulant and blood circulation enhancing properties. The aim of the study is to evaluate the effect of Jalaukavcharana (Leech Therapy) in the Perianal hematoma. A 42-year male patient having complains of pain and swelling in perianal region diagnosed as perianal hematoma in Shalya OPD of GAC Nagpur. Treatment of choice was Jalaukavacharana with three sittings given at alternate days and it was found to be very effective in Perianal Hematoma.