Aim — to compare the results of hemorrhoidectomy performed with an ultrasonic scalpel and monopolar coagulation. Methods. A retrospective analysis of data of 48 patients who underwent hemorrhoidectomy for internal hemorrhoids of 3 and 4 stage was performed. Removal of hemorrhoids and coagulation of the leg of the node was performed using an ultrasonic scalpel in the main group (n=24) and monopolar coagulation with stitching of the leg with PGA thread 3-0 in the control group (n=24). Results. General patient performance, clinical characteristics, and length of hospital stay were the comparable in groups. Compared with the control group, the main group had a shorter operation time (p<0.005), less postoperative pain on a visual analog scale (p<0.05 on the 3rd postoperative day) and less postoperative bleeding (p=0.035). There were no significant differences in postoperative complications between two groups. Conclusions. Hemorrhoidectomy with an ultrasound scalpel is an effective and safe procedure, which reduces the time of surgery, postoperative blood loss and postoperative pain. Long-term follow-up and more patients in the study are needed to assess late complications and quality of life after hemorrhoidectomy with an ultrasound scalpel.