Surgical treatment is considered to be the best therapeuticmodality for severe haemorrhoidal disease (third and fourthdegree haemorrhoids). Different surgical methods aim to decreasepain, bleeding, stenosis and discharge. The aim of this study is toevaluate the efficacy of the Harmonic scalpel haemorrhoidectomy.A group of patients with third and fourth degreeshaemorrhoids where followed up over a period of six months.Patients were prospectively randomized for harmonic scalpelhaemorrhoidectomy or traditional Milligan Morgan procedure.The patients where examined at day 1, 2, 7 and followed up forthree to six months following surgery. All patients had a lowergastrointestinal investigation prior to operation to exclude othercolorectal pathologies. All patients had the same kind ofpreoperative preparation. The types of intra-operative anesthesiaadministered to the two groups were similar. Pain was assessedusing a scale from one to four. Patient’s satisfaction was definedas decrease or absence of symptoms and return to normal dailyactivities. We found that those who underwent Harmonic ScalpelHaemorrhoidectomy HS group relative to the patients whounderwent Milligan Morgan haemorrhoidectomy MM group hadless pain during the first week postoperatively. Early complicationsoccurred more frequently in MM group. In conclusion, harmonic scalpel haemorrhoidectomy isvirtually a bloodless operation with minimal tissue damage.