Objective To compare efficacy of procedure for prolapse and hemorrhoids (PPH) and rubber band ligation (RBL) in treatment of Ⅲ degree internal hemorrhoids.Methods One hundred patients with Ⅲ degree internal hemorrhoids were randomly divided into two groups and received PPH (42 cases) and RBL (58 cases) respectively.At once and after two weeks and two and six months the efficacy were compared.Results PPH and RBL were equally effective in controlling symptomatic prohpse (P>0.05),but RBL was associated with an increased incidence of recurrent bleeding (PPH 8/42 vs RBL 30/58,P<0.05);there was no difference in scores of patient satisfaction (P>0.05); PPH was associated with increased pain and analgesia usage at both at once and 2-week follow-up (P<0.05);the rate of complications in PPH was higber than in RBL (7/42 vs 0/58,P<0.05).Conclusion RBL can be used as treatment of first-line treatment of Ⅲ degree internal hemorrhoids.