PURPOSE:To review the long‐term results of anterior levatorplasty for fecal incontinence.METHODS:Fifty‐four women with obstetric trauma and 31 with idiopathic incontinence responded to a questionnaire 1.5 to 18.5 (median, 8.5) years after anterior levatorplasty. Results were classified as excellent, good, fair, or poor.RESULTS:An excellent or good result was reported in 40 of 54 (74 percent) patients with an obstetric injury and in 14 of 31 (45 percent) patients in the idiopathic group (P<0.01). The presence of a cloaca(P<0.05) and a young age(P<0.05) were associated with a favorable outcome in the obstetric and idiopathic group, respectively. Length of follow‐up and preoperative severity of incontinence were not significantly related to outcome.CONCLUSIONS:This study suggests that every second patient undergoing anterior levatorplasty for fecal incontinence has a successful result that is sustained in the long term. Obstetric trauma, presence of a cloaca, and young age are associated with a successful outcome.