The imperforate anus is a spectrum of anorectal malformation ranging from membranous separations to the complete absence of anus. A total of 68 patients with imperforate anus were studied retrospectively during the period from January 2014 to December 2018. Information regarding age, sex, family history, maternal age and disease were obtained. All cases were diagnosed by inspection. Lateral decubitus or upright x-ray was done for all patients to differentiate various types. renal ultrasound, cystogram, spinal ultrasound, echocardiography, and spinal MRI. This study was carried out to find out the rate of different associated anomalies and the commonest types of anomalies and their sex distribution. Results revealed that the coexistence of ARMs and additional anomalies were found in 27.9% of infants. Associated anomalies by major organ systems included genitourinary anomalies (10.3%), musculoskeletal anomalies (2.9%), cardiovascular anomalies (4.4%), gastrointestinal anomalies (1.47%). The most common chromosomal abnormalities were trisomies (8.8%). In conclusion, this study confirmed the association of anomalies with the imperforate anus is more common in low compared with high type, and this necessitates investigation other than plain x-ray regardless the type of ARMs.