Transanal Doppler-guided artery ligation of the terminal branches of the superior hemorrhoidal artery, combined with transanal rectal mucopexy (TRM) is a novel minimally invasive technique for the treatment of symptomatic hemorrhoids stage III and IV. Because of its novelty, the effectiveness of the technique still has not been properly assessed. The study aimed to describe the author's experience in using the method in 180 patients (128 men, 52 women; mean age 43.8±9.13 years), of the 26 patients had previously been operated on. The mean follow-up time was 42 months (36-60). Bleeding resolved in 161 (90.4%) and prolapse disappeared in 160 (88.9%) patients within 40 months after the operation. Thus, transanal Doppler-guided hemorrhoidal artery ligation with transanal rectal mucopexy should be considered as an effective option for the treatment of hemorrhoids stage III-IV.