Abstract: Objective To investigate the clinical effect of automatic hemorrhoids ligation(RPH,modified rubber band ligation) and Milligan-Morgan Hemorrhoidectomy(M-M) in treatment of patients with Ⅲ or Ⅳ degree mixed hemorrhoids. Methods Total 164 cases of Ⅲ or Ⅳ degree Mixed hemorrhoids in our hospital from January 2013 to December 2014 were randomly divided into observation group and control group,with 82 cases in each group.The patients in the control group were given Milligan-Morgan Hemorrhoidectomy(M-M),while the patients in the observation group were given automatically hemorrhoids ligation(RPH).The wound healing time,clinical efficacy and complications(anal margin edema,bleeding,skin tag forming,dysuria,and pain) of both groups were observed. Results The wound healing time of the observation group was (21.5±4.9) d,which was significantly shorter than that in the control group[(25.1±6.2)d],P＜0.05.The total effective rate of the observation group was 95.1%,which was significantly higher than that in the control group 84.1%(P＜0.05).The anal margin edema,bleeding,skin tag forming,dysuria,and pain status of the observation group were 2.2±0.7,3.6±0.9,2.1±0.6,3.1±0.8,8 cases,respectively,which were significantly better than control group(2.9±0.8,4.1±1.1,2.7±0.8,3.9±0.9,and 20 cases,respectively),P＜0.05. Conclusion Compared with traditional Milligan-Morgan Hemorrhoidectomy,automatic hemorrhoid ligation can effectively treat Ⅲ or Ⅳ degree mixed hemorrhoids,with advantage of short wound healing time,high efficacy and low complication.