This case report is on a very rare case of giant anal canal ulcer with rectal prolapse causing total faecal incontinence. An elderly patient in her eighties presented to the emergency department with complaints of a mass protruding thorough anus along with fresh rectal bleeding. Examination revealed a large ulcer measuring 6 cm × 8 cm involving the entire anal canal with rectal prolapse. Here, we discuss the management of this patient with a rare cause of giant anal canal ulceration.