Obstetric anal sphincter injuries are complications occurred during vaginal delivery. An inadequate of this condition may lead to the total perineal rupture. One of the symptoms is anal incontinence. This condition may interfere with the patient's quality of life. This study aims to present symptoms, risk factors and surgical management in old total perineal rupture cases. We presented seven cases of old total perineal rupture, from March 2021 until March 2022. All the patients had a chief complaint of anal incontinence. All patients had previous primary suturing at the time of delivery. From the sphincter US examination, all the patients had a defect on the internal and external ani sphincter. The overlapping sphincteroplasty and perineorrhaphy technique was performed in all patients. Identification of perineal lacerations and their immediate treatment are very important to prevent the occurrence of old total perineal rupture. Management with the overlapping sphincteroplasty and perineorrhaphy is an effective technique to correct this condition.