A unpleasant ailment called a recto-vaginal fistula (RVF) is one in which the rectum and vagina do not communicate normally, allowing feces and gas to pass through. In-depth analysis of RVF, including its genesis, clinical manifestation, diagnostic techniques, accessible treatment modalities, and preventive measures, is the goal of this in-depth review paper. Twenty pertinent references from reliable sources were chosen after a thorough search of the PubMed database to support the data in this research. Congenital or acquired, the most common causes of RVFs include obstetric trauma, pelvic surgery, inflammatory bowel disease, radiation therapy, and cancer. To reduce the negative effects of RVFs on the body, mind, and society, early detection and adequate management are crucial. Endoscopy, contrast investigations, and magnetic resonance imaging are examples of diagnostic techniques. Depending on the size, location, and etiology of the fistula, the range of treatment options includes everything from conservative therapy to surgical surgery. Correct obstetric care, thorough surgical methods, proactive inflammatory bowel disease management, and radiation therapy planning are all examples of preventive tactics. Future studies ought to concentrate on enhancing diagnostic methods, perfecting surgical procedures, and identifying high-risk individuals for specialized preventive measures. In order to improve results and the quality of life for those affected by RVFs, multidisciplinary care and patient-centered strategies are essential.