Two groups of 18 patients undergoing sclerosant injection or rubber band ligation for first or mild, second degree hemorrhoids have been followed-up at three years after the initial treatment. Following sclerosant injections, four of 18 patients initially presenting with bleeding per rectum did not have further episodes of bleeding within the three year follow-up period compared with 13 of 17 treated with rubber band ligation. The other symptoms of pain or discomfort, pruritus ani and soiling were not present with sufficient frequency to allow specific evaluation. Results of this study demonstrate that rubber band ligation produces better long term results than does sclerosant injection in treating bleeding, the principal symptom, of first and mild, second degree hemorrhoids.