Introduction: Rectovesical fistula is a rare but devastating complication of radical prostatectomy. The management of this condition is complex and often requires a multidisciplinary approach. We present a case series of three patients who underwent successful repair of rectovesical fistula using a pedicled gracilis flap interposition graft. Methods: A retrospective review of three patients who underwent repair of rectovesical fistula following radical prostatectomy between 2023 and 2024 was performed. Data on patient presentation, surgical technique, and postoperative outcomes were collected and analyzed. Results: All three patients presented with pneumaturia and fecaluria. The diagnosis was confirmed by cystogram and/or CT scan. All patients underwent a delayed repair with a diverting colostomy, followed by fistula repair with a pedicled gracilis flap interposition graft. All three patients had a successful outcome with resolution of their symptoms and no evidence of fistula recurrence at a mean follow-up of 12 months. Conclusion: The pedicled gracilis flap interposition graft is a safe and effective technique for the repair of rectovesical fistula following radical prostatectomy. This technique provides a robust and well-vascularized tissue barrier between the rectum and bladder, which is essential for successful fistula closure. We believe that this technique should be considered in the armamentarium of the surgeon dealing with this challenging clinical problem.