Perianal resection for neoplasia is associated with a significant risk for subsequent fecal incontinence. This report describes primary reconstruction of the anus using local skin flaps in nine patients who had undergone resection of perianal tissue for neoplasia. Seven patients had invasive cancer, and two patients had carcinoma in situ with a preoperative suspicion of invasive cancer. In all nine patients a portion of the external anal sphincter was excised during surgery. Bilateral rhomboid flaps were used in five patients, and four patients had advancement of local full-thickness skin flaps. All nine patients had a satisfactory anatomic result and were ultimately fecally continent.