Abstract: Objective To investigate the clinical effect of traditional internal ligation as well as external exlising and automatic hemorrhoid ligation combined with external excision in the treatment of moderate to severe mixed hemorrhoids. Methods A total of 92 patients with moderate to severe mixed hemorrhoids were selected, and were divided into study group and control group according to the random number table method. The control group(n=46)was treated with traditional internal ligation as well as external exlising, and the study group was treated with automatic hemorrhoids ligation combined with external resection. The related indexes, clinical effect and complication rate were compared between the two groups. Results The operative time, wound healing time and hospitalization time of the study group were significantly shorter than those of the control group, the amount of intraoperative bleeding in the study group was significantly less than that in the control group(P<0.05). The total effective rate of clinical treatment in the study group was 95.65%, which was significantly higher than 80.43% in the control group(P<0.05). The total complication rate of the study group was 23.91%, which was significantly lower than 54.35% of the control group(P<0.05). Conclusion Automatic hemorrhoid ligation combined with external resection for moderate and severe mixed hemorrhoids has remarkable curative effect, and it has minimal invasion, and less complications.