Abstract: Objective To investigate the effect of hemorrhoid artery ligation and rectal anal repair under Doppler ultrasound guidance and its effect on anal pressure of hemorrhoids patients. Methods Two hundred and six patients with stage Ⅲ-Ⅳhemorrhagic disease were randomly divided into two groups, each 103 cases. The control group was treated with external stripping ligation, and the observation group was treated with hemorrhoid artery ligation and rectal anal repair under Doppler ultrasound guidance. After treatment, the clinical efficacy, postoperative complications (bleeding, edema, urinary retention, bulging sense), postoperative VAS score, anorectal manometry (ARP, RRP, AMCP) and recent recurrence of the two groups were compared. Results After treatment, the total effective rate of observation group was 97.06%, which was significantly higher than that of control group (89.32%), P<0.05. The bleeding, edema, urinary retention and bulging scores of observation group were lower than those of control group, the difference was statistically significant (P<0.05). After operation, the VAS score of observation group was significantly lower than that of control group, the difference was statistically significant (P<0.05). After treatment, the ARP, BRP and AMCP levels of two groups were significantly reduced (P<0.05), and observation group was significantly higher than those of control group, the difference was statistically significant (P<0.05). There was no significant difference in the recurrence rate between the two groups (P>0.05). Conclusion Hemorrhoid artery ligation and rectal anal repair under Doppler ultrasound guidance could treat hemorrhoid disease significantly, significantly reduce the postoperative complications, reduce pain, and stable normal anal contraction function.