Abstract : Symptomatic haemorrhoids is a disease encountered in general surgery practice and has a high prevalence worldwide. Newer technique has been introduced such as laser therapy, Doppler guided haemorrhoidal artey ligation, stapler haemorrhoidectomy whose relevance and efficacy has to be carefully evaluated in a resource poor country like India, in comparision to more tradional and cost effective approach like open haemorrhoidectomy. Hence the aim of the study was to compare stapler haemorrhoidectomy versus open haemorrhoidectomy in the management of grade III and IV haemorrhoids. A prospective cohort study of 60 patients were taken for the study and were divided into 2 groups of 30 each. In our study the mean duration of surgery in stapler haemorrhoidectomy was (37.83 mins) in comparision to (44.50mins) open haemorrhoidectomy. The mean pain score after stapler haemorrhoidectomy was (1.08) which was lower than open haemorrhoidectomy (3.20). Mean duration of hospital stay in stapler haemorrhoidectomy was (2.57 days) which was lower than open haemorrhoidectomy (7.23days). Mean duration to resume daily activity in stapler haemorrhoidectomy was (5.57 days) which was lower than open haemorrhoidectomy (12.6 days). Higher post-operative complications were observed among open haemorrhoidectomy patients. Stapler haemorhhoidectomy is as effective as open haemorrhoidectomy in relieving symptoms as long as the symptoms are directly related to the prolapse of haemorrhoids. Although in India, financial aspect is a major factor which needs consideration, weighing the pros and cons of both these surgical techniques, stapler haemorrhoidectomy can be considered as a good alternative to conventional open haemorrhoidectomy.