Pickrell procedure or non stimulated gracilis Muscle transposition is used for the management of severe fecal incontinence. We report four males and one female, aged 6 to 68 years, with severe incontinence, that were operated. Surgical complications were wound dehiscence in two patients, a deep venous thrombosis in one patient and chronic pain in the zone of muscle insertion in one patient. There was an improvement in the voluntary contraction pressure of the sphincter in four of five patients and a significant reduction in the incontinence score.