PURPOSE: We report a single case of proctalgia fugax that responded to 0.3 percent nitroglycerin ointment. METHODS: Case report. RESULTS: A single case of proctalgia fugax responded to topical application of 0.3 percent nitroglycerin ointment with no significant side effects. CONCLUSIONS: Nitroglycerin ointment is a newly described treatment for several painful anal conditions. We describe a single case of levator spasm or proctalgia fugax responding to topical application of nitroglycerin. This is only a single case report, and conclusive evidence awaits completion of a controlled clinical trial.