There is now sufficient data in the literature to compare pedicular hemorroidectomy (Milligan and Morgan, Ferguson), the reference operation, to the Longo procedure (stapled hemorrhoidopexy) (SH). SH is easy to perform, is associated with less pain and allows early return to normal activities. Not withstanding a higher risk of recurrence and some degree of procidentia, the long-term level of patient satisfaction is high after SH. Strict patient selection is necessary: patients should have reversible prolapse, normal anal caliber, and absence of large tags. This procedure is not recommended for stage IV disease. In case of persistent prolapse or hemorrhoidal recurrence after SH, elastic band ligation should be preferred.