Fecal incontinence, the loss of anal sphincter control leading to the unwanted release of stool or gas, is a physical and psychological handicap that has a tremendous impact on an individual's quality of life. Although medical management is the mainstay of therapy for fecal incontinence, the main focus in this review is on invasive techniques with a goal of highlighting newer technologic and therapeutic advancements. While the standard surgical treatment for fecal incontinence still remains direct sphincter repair with an overlapping sphincteroplasty, this review concentrates specifically on biofeedback, the Procon incontinence device, local injection of synthetic materials, radio frequency energy (Secca procedure), antegrade colonic enemas, sphincteroplasty, gluteoplasty, graciloplasty both stimulated and non-stimulated, the artificial bowel sphincter, and sacral nerve stimulation.