Crohn’s disease (CD) commonly causes perianal fistulas (PF), which are difficult and costly to treat. With 10% having PF present at CD diagnosis, delay in diagnosis is associated with worse outcomes. Furthermore, >20% develop PF later, with few reliable predictors, and preventive strategies are nonexistent. We sought to characterize the variation in CD diagnosis to identify potential predictors of PF development. We hypothesize that timely diagnosis and treatment is associated with lower rate of PF development.