This study discusses the management of hemorrhoids by rubber band ligation. It reviews 233 rubber band ligation procedures in 148 patients with symptomatic hemorrhoids performed over a 5-year period. 72% of the patients underwent a single rubber band ligation, 22% a double band ligation and 6% a triple band ligation in one session without anesthesia. A follow-up of 18 +/- 5 months was carried out. Only three patients required hospitalization for complications. One patient was admitted for bleeding and recovered with clot evacuation, bed rest and blood transfusion. Two patients developed a band related abscess that resolved with drainage. Twenty patients (13.5%) reported pain associated with the procedure. Four patients needed subsequent surgical hemorrhoidectomy. Long-term results were good in 81.2% of the patients. This report agrees with previously published series showing the efficacy and cost containment of hemorrhoidal ligation.