Introduction :Hemorrhoidal disease is nearly present in 5% of the community and more likely after the age of 40. Pain is one of the most distressing symptom of conventional treatment of hemorrhoids Different treatment methods are used for hemorrhoids, Surgery is indicated for the third and fourth grade hemorrhoidal disease . We compared the outcome of conventional Milligan Morgan hemorrhoidectomy for symptomatic third and fourth grade hemorrhoids. Materials and methods: This is a randomized control study in which 60 patients with symptomatic third and fourth-grade hemorrhoids were included results are compared regarding pain ,bleeding ,operative time ,healing time and postoperative complications. Results: The mean age of the conventional group patients was 36.5 ± 4.9 years with a male: female ratio of 21:9 while the mean age of LigaSure group patients was 37.30 ± 4.03 years with a male: female ratio of 19:11 In conventional hemorrhoidectomy, the mean operative time was 27.25min (SD±6.53). In LigaSure hemorrhoidectomy, the mean operative time was 15.83 (SD±2.32). P value <0.001. intra operative bleeding was less in ligasure group p value < 0.022 The mean Pain score on 1st day postoperative was 5.59 (SD±1.76) in conventional hemorrhoidectomy, While in LigaSure hemorrhoidectomy the Mean Pain score on 1st day postoperative was 2.63 (SD±2.47) P value < 0.001 . Wound discharge and infection were statistically much less in the LigaSure group (P value <0.006 )The mean wound healing time In conventional hemorrhoidectomy was 4.59 weeks (SD±0.48) P value < 0.05. In LigaSure hemorrhoidectomy, the mean wound healing time was 2.53 weeks (SD±0.52). Conclusion: LigaSure hemorrhoidectomy is a sutureless, It depends on on a electrosurgical energy source to achieve tissue and vessel sealing. It is feasible and safe with fewer complications mainly less postoperative pain and less intraoperative blood loss when comparing it to conventional technique. Technically simple because there is no suturing and hemostasis is easy to achieve. The drawback is the cost .