BACKGROUND: Hemorrhoidal disease is characterized by painless rectal bleeding and palpable swelling in the anus and very common in the society. In the presence of pain, it is called a complicated hemorrhoidal disease including conditions, such as thrombosed hemorrhoids, strangulation of the internal hemorrhoid, or accompanying anal fissure. Edema that develops as a result of impaired venous return is accepted as the main source of pathology in the development of strangulated internal hemorrhoidal disease, which is one of these complicated conditions. CASE PRESENTATION: This case report shows that strangulated hemorrhoidal disease can also develop due to a mechanical cause as a result of incarceration of the hemorrhoid into the accompanying perianal fistula tract.