{Reference Type}: Case Reports {Title}: Rectal perforation after laser hemorrhoidoplasty: a case report. {Author}: Smets Q;Gaillard M;Van de Weijer M;Komen N; {Journal}: Tech Coloproctol {Volume}: 28 {Issue}: 1 {Year}: 2024 Jun 7 {Factor}: 3.699 {DOI}: 10.1007/s10151-024-02939-x {Abstract}: This case report outlines the intricate management of rectal perforation following laser hemorrhoidoplasty in a 31-year-old female, leading to an acute abdomen, sepsis, and multiorgan failure. Urgent laparoscopic exploration and the establishment of a double-loop colostomy were undertaken, marking the beginning of a complex course characterized by relapsed pelvic sepsis. Laser hemorrhoidoplasty has gained widespread acceptance for its minimally invasive approach in treating hemorrhoids. Remarkably, to our knowledge, the case we present is the first major complication reported after laser hemorrhoidoplasty, likely attributed to collateral thermic and mechanical tissue damage.