Hemorrhoids are the common benign anal problems in rural India and usually the patients present to the surgical outpatient department at late stage. This prospective randomized clinical trial is aimed to compare the results of classical versus stapled hemorrhoidopexy for treatment of third and fourth degree hemorrhoids. Objective: We report our experience on surgical treatment focusing on postoperative pain, complications and days to return normal activities after the procedure Methods: 106 patients admitted for surgical treatment with class III/IV hemorrhoids from June 2011 to May 2013 were randomly assigned to classical (n=53) or stapled hemorrhoidopexy (n=53).The outcomes included in form of post operative pain, procedure time, number of days taken to return to work, post-operative bleeding, acute urinary retention, need of dressings, and anal stricture were compared. The patients were followed up to 3 years for recurrence of symptoms. Results: Stapled procedure group had less postoperative pain, earlier return to normal activity and less recurrence after 3 years of the study. There is no need of Seitz bath after stapled procedure Conclusion: Stapled hemorrhoidopexy is an effective alternative treatment for third and fourth degree hemorrhoids with significant advantages for patients compared with traditional open hemorrhoidectomy.