Introduction Rectovesical fistula (RVF) is defined as an extra-anatomic communication between the rectum and bladder. Multiple approaches have been described; however there is a lack of consensus regarding which of these procedures is the optimal technique. We describe the repair of a persistent RVF via a transperineal approach, utilising the dartos fascia flap, a minimally described technique. Methodology Our treatment algorithm includes pre-operative cystoscopy and CT cystogram to assess for leak. Cystoscopy identifies the fistula track; a guide wire is passed to aid dissection and visualisation of the vesical fistula. In supine position, the patient has a Blandy incision (inverted U-Shape) into the perineum, with careful dissection down to the bulbar urethra. Once both fistulae opening are widely separated; it is closed with two layers of interrupted 4.0 PDS suture. A dartos muscle flap is harvested and interposed between the repaired fistulae. A foley’s catheter is placed for 6 weeks before cystogram; after which bowel diversion is restored 6 weeks post catheter removal. Results We have used this technique to treat RVF in 17 patients, with excellent results. Regarding outcomes - one patient developed recurrence, which resolved with conservative management; one patient developed urethral diverticulum which required trans perineal repair and one patient’s repair for a large iatrogenic RVF failed, requiring cystectomy. Conclusion We present our experience with using the dartos flap repair of rectovesical fistulae, adding to the literature in this area. This novel dartos flap has advantages of being easily harvested; being adequate length for interposition with reliable blood supply and minimal morbidity.