&NA;Internal hemorrhoidectomy by elastic ligation is employed at Cleveland Clinic Foundation for the symptoms of annoying prolapse and/or painless anal bleeding in patients who have normal bowel function or who have irritable bowel under optimal management instruction. Results of this treatment in 286 patients selected at random are reported. The procedure was well accepted by more than 75 per cent of the patients, and two thirds of them reported little or no discomfort. Time lost from work was a small fraction of that which would have resulted had conventional excisional treatment been employed instead.Careful selection of patients should minimize the disadvantages and enhance the advantages of this generally less traumatic and certainly less costly method of treating patients with symptomatic internal hemorrhoids.