The results after gracilis muscle transposition were studied in ten patients with a follow-up of six months to 17 years. Nine patients were continent for formed feces and the condition of one patient worsened after operation. Anorectal manometry was performed in eight of the ten patients. Evaluation of pressure recordings showed a normal image, both at rest and at maximal squeeze, in five patients. Low-pressure recordings at rest and at maximal squeeze were seen in two continent patients, in whom the tissue scarring resulted in narrowing of the anal canal. One patient with low-pressure recordings was completely incontinent. An attempt was made to explain the continence and low-pressure recordings. The results suggest gracilis muscle transposition to be a method of choice in patients with total incontinence who have no functional anal sphincter.