Abstract Introduction: Hemorrhoids (HD) is one of the most common anorectal disorders. Although multiple treatment options exist, each treatment option has its limitations. Rubber band ligation (RBL) is a non-operative outpatient treatment of internal Hemorrhoids (IHD). It does not require anesthesia and has less risk of complications. Aim: to determine the efficacy of RBL in treating grade II and III HD. Materials and methods: this is a prospective study of 90 patients with grade II and III HD.RBL was applied to all HD patients at the same session in an outpatient clinic. After 3 weeks symptomatic patients had a proctoscopy examination and a second RBL session was repeated if HD was present. After 6 weeks, all patients had proctoscopy. Asymptomatic patients with negative proctoscopy were declared cured. All patients who had symptoms and /or with positive proctoscopy were stated failure. Follow-up of cured cases continued until the end of the 12th week to detect the recurrence cases. Results: the cure rate, failure rate, and recurrence rates were 83.33%, 13.34 %, and 3.33 %respectively. Pain and bleeding were the most common complications. Both were limited and resolved with conservative management. Conclusion: RBL has low morbidity and fewer complications which can be managed conservatively. It has a low short-term recurrence rate. The success rate may increase by elongating the follow-up period with repeated sessions for non-responding or recurrent HD patients.