Background <p>Rectovaginal fistulas (RVF) are a&#xa0;rare condition. The majority of RVF are of traumatic origin (childbirth, local infections, rectal surgery). Rectovaginal fistulas in chronic inflammatory bowel disease represent a&#xa0;special entity.</p> Method <p>A&#xa0;rectovaginal fistula can usually only be definitively healed by surgical means. Various surgical procedures with a&#xa0;low level of evidence have been described in the literature. The access to close the fistula can be transrectal, transperineal or transvaginal. The transperineal approach is primarily used for simultaneous sphincter reconstruction. The suture can be supported by interposition of autologous tissue (Martius flap, gracilis muscle) or biomaterials. The indications for stoma creation should primarily depend on the extent of the local defect and the resulting burden on the affected woman.</p> Results <p>This article describes the technique of transvaginal closure with coverage using a Martius fat flap.</p> Conclusion <p>The transvaginal approach reinforced with a&#xa0;Martius fat flap enables good visibility and safe surgical closure of a&#xa0;rectovaginal fistula.</p>