Rubber band ligation (RBL) was prospectively used in 49 consecutive patients with bleeding internal hemorrhoids between 1987 and 1990. All patients underwent a two year follow-up period. Ten patients experienced complications consisting of pain, bleeding, mild discomfort and dissatisfaction. Hemorrhoidectomy was required in three patients. Long term results were satisfactory in 93.9 percent of the patients. The results of this study confirm that single session RBL is a valuable alternative to hemorrhoidectomy in selected patients.