Background: Anal fissure is common with inflammatory bowel diseases. Management of anal fissure in those patients is complex. This study seeks improving the quality of life in patients with inflammatory bowel disease and anal fissures by comparing the outcomes of laser sphincterolysis and lateral internal sphincterotomy in those patients. Methods: This is a single-institution comparative randomized clinical study which was done in colorectal unit in surgery department from September 2023 to September 2024. Sixty patients with anal fissures and inflammatory bowel disease were enrolled in the study. Patients were randomly selected in two groups; Group I who had laser sphincterolysis, and Group II who underwent lateral internal sphincterotomy. Results: Laser group outformed the lateral internal sphincterotomy group by operative time, pain scale and duration, postoperative anal discharge, time to return to work, and patient satisfaction (P < 0.001). Conclusions: laser sphincterolysis is better than lateral internal sphincterotomy for anal fissures in inflammatory bowel patients.