Introduction and objective: The aim of this study was to evaluate the three-dimensional image of anal sphincter muscle complex which obtained from 3D anorectal manometry in children who underwent surgery for congenital anorectal defects. Materials and methods: The study group included 48 children operated on at the Polish Mother's Memorial Hospital – Research Institute from 2000 to 2020 due to anorectal malformations. All operations were performed using Peña’s posterior sagittal anorectoplasty method. The reference group consisted of 28 children with no history of motility disorders of the distal gastrointestinal tract. Three-dimensional high-resolution anorectal manometry was performed in all children. The threedimensional image of the anal sphincter complex was analysed in terms of its symmetry. The percentage of differences in the pressures in the images of both sides of the anal sphincter muscle, during squeeze and at rest, was calculated. Based on the pressure map, the puborectal muscle was visualised. Results: Asymmetry in the 3D image of the anal sphincter complex at rest and during squeeze in the study and reference groups was shown. In the study group, the mean percentage of asymmetry was 18% at rest, while in the reference group, it was 8%. It was 21% and 5%, respectively, during squeeze. In every patient in the reference group, the obtained image the identification of the puborectalis muscle. An image corresponding to this muscle was registered only in 22 patients (45%) in the study group. Conclusions: The techniques used in 3D high-resolution anorectal manometry provide the ability to reconstruct a computer image of the respective muscles of the anal sphincter complex and assess their contribution to the continence process.