Background: About half of the population has hemorrhoids by the age of fifty years. Hemorrhoidectomy is considered the gold standard, and Milligan-Morgan hemorrhoidectomy is the most widely used technique worldwide. This study aimed to compare two techniques of open hemorrhoidectomy, clamp and diathermy hemorrhoidectomy and Milligan-Morgan hemorrhoidectomy. Patients and methods: Eighty-four patients with 3rd or 4th-degree hemorrhoids were randomly subdivided into two groups; group (I) was managed by clamp and diathermy hemorrhoidectomy, the hemorrhoid was excised over an artery clamp using spray diathermy with no dissection, and group (II) was managed by Milligan-Morgan hemorrhoidectomy. Results: The patients were subdivided into two groups, 42 patients in each group. The operative time was shorter in group (I) than in group (II), p-value < 0.05%. Intraoperative blood loss was significantly less in group (I), 3.0 ml versus 6.57±1.78 ml in group (II), p<0.05%. The time for complete wound healing was shorter in group (I), 16.59± 2.379 days vs 24.54± 3.255 days in group (II), p<0.05%. Regarding incontinence, there was no statistically significant difference of Wexner score for incontinence form preoperative to 3 months postoperatively in each group, p-value= 0.323 and 0.160 in group (I) and group (II) respectively. Conclusion: Clamp and diathermy technique is an effective method in the treatment of 3rd and 4th-degree hemorrhoids with rapid healing if compared to Milligan-Morgan hemorrhoidectomy. Keywords: hemorrhoids, open hemorrhoidectomy