&NA;Using a microtip pressure transducer, anorectal manometry was performed in 119 patients with symptomatic hemorrhoids. In 96 patients (80.7 percent), a high anal pressure (>125 cm/H2O) was found. These patients were treated by lateral internal sphincterotomy, carried out under local anesthesia. In 23 patients 919.3 percent), a normal or low anal pressure (<125 cm/H2O) was found. These patients were treated by band ligation or hemorrhoidectomy. The clinical results after lateral internal sphincterotomy (success rate, 75.3 percent) suggest that this procedure is a good alternative in selected patients.