Background: Even with day-care procedures gaining popularity, excisional hemorrhoidectomy still remains the most effective treatment in Grade III/IV hemorrhoids and Grade II hemorrhoids that do not respond to medicines. People with hemorrhoids tend to self-medicate instead of seeking proper help, and only 1/3rd of patients present to a physician for treatment. An alternate mode of anesthesia that bridges the gap between day-care procedures and traditional excisional hemorrhoidectomy could help overcome this limitation. Objectives: The study aimed to compare local and spinal anesthesia for open hemorrhoidectomy in terms of post op-pain, complications, analgesia, and hospital stay.