Objective The objective was to compare outcomes of primary end-to-end repair versus overlap repair of the external anal sphincter following obstetric anal sphincter injuries. Materials and methods This study was carried on 30 patients with obstetric anal sphincter injuries in the Department of General Surgery, Zagazig University Hospitals, during the period from May 2015 to June 2017. The patients divided into two groups: group A was managed primarily with end-to-end repair technique of external anal sphincter and group B was managed using overlap repair technique. Results The age of the studied patients in group A ranged from 25 to 56 years, with mean of 30.8±9.9 years, and in group B, it ranged from 23 to 59 years, with mean of 31.5±8.2 years. Group A has shorter operative time and less intraoperative bleeding, with no difference between both the groups regarding fecal incontinence, flatus incontinence, dyspareunia, and perineal pain. Conclusion Obstetric anal sphincter damage and related fecal incontinence are common and can cause long-term sequelae if not detected and corrected. End-to-end repair is a simple operation that has shorter operative time and less intraoperative bleeding; however, there was no significant difference between both the groups regarding fecal incontinence, flatus incontinence, perineal pain, and dyspareunia. Early sphincter repair by a skilled surgeon minimizes the associated morbidity.