Background: Rectovaginal fistulas (RVFs) are abnormal, epithelialized communications between the posterior vaginal wall and the anterior rectal wall, most commonly resulting from obstetric trauma. They can lead to significant physical and psychological morbidity. Objective: To describe the clinical presentation, management strategies, outcomes, and preventive measures in patients with obstetric RVFs treated at HMA Hospital, Marrakech. Methods: A retrospective study of 10 patients with obstetric RVFs managed over a one-year period (November 2023 – November 2024). Data collected included patient demographics, obstetric history, clinical features, diagnostic findings, surgical techniques, and postoperative outcomes. All patients underwent transperineal repair using Musset’s technique, with colostomy performed when indicated. Results: Obstetric RVFs accounted for 66.6% of all RVFs operated on in the department. Mean patient age was 29 years; six patients were primiparous. Deliveries occurred at home (3), in maternity centers (3), and hospitals (4). Surgical repair was performed in all patients using Musset’s technique; nine patients received a left iliac colostomy. Postoperative recovery was uneventful in nine patients. One recurrence occurred in a patient who initially refused colostomy; she was successfully reoperated. Conclusion: Obstetric RVFs predominantly affect the lower two-thirds of the vagina. Surgical repair is highly effective, preventing major complications and facilitating patient reintegration. Prevention through patient education, prenatal care, and improved obstetric services remains essential.