Background: Haemorrhoidal disease is a common cause of anorectal complaints in our region. This condition is typically managed with open surgery. While open surgical techniques have been shown to be durable methods of treatment, they are typically done using general or regional anaesthesia. They also are associated with a high complication rate and intense operative pain. However, in recent time, minimally invasive procedures such as rubber band ligation (RBL) and injection sclerotherapy (IS) have been gaining in popularity and acceptance by surgeons and patients as the post operative pain is much lower. They can also be deployed without the need for anaesthesia and as a day case procedure. Aims: This study was aimed at assessing and comparing the success rate and complication rate of RBL and IS in the management of symptomatic grades I-III internal haemorrhoids. Method: Seventy four patients were recruited and randomly allotted to have either RBL or IS as a treatment modality. All participants had a session of bowel preparation comprising low residue diet the day before and ingestion of 10 mg of dulcolax the evening before their scheduled procedure. At proctoscopy, a pair of rubber bands were placed at the apex of each enlarged haemorrhoid in the RBL group using a Barron rubber band ligator, while 3% polidocanol (hydroxy-polyethoxy-dodecanone; Samarth Life Sciences PVT Ltd, India; Batch number DA2703) was injected into the submucosa in the IS group with the aid of a syringe and 32mm 18G hollow needle after which all patients were followed up for 3 months after treatment. Severity of symptom was estimated using the Sodergren haemorrhoid symptom severity score. Patients who had no improvements in their Sodergren scores after 3 treatment sessions were classified as failed treatment. Continuous variables were expressed as means and standard deviations while categorical variables were expressed in proportions. Where data was normally distributed, means were compared with student’s t test and a p value < 0.05 was accepted as statistically significant. In cases where the data was not normally distributed, the Wilcoxon sign rank tests and Mann Whitney U tests were used to compare means within and between treatment groups respectively, with a z value of between -1.96 and 1.96 accepted as not being statistical significant. Results: Both treatment modalities were observed to be effective in ameliorating the symptoms of grades I-III haemorrhoids. Resolution of symptoms occurring in 86.5% of patients in the RBL group and 78.4% of patients in the IS group. The difference in the success rate was not statistically significant (p = 0.506). The success rate was also not significantly different in both groups for all grades of haemorrhoid studied (p = 0.153), however grades II and III of haemorrhoids required multiple therapy sessions to achieve control of symptoms when compared with grade I (p = 0.001). Post operative pain was significantly higher in the RBL group compared with IS (z = -4.56) and the mean duration of treatment sessions was also significantly higher in the RBL group compared with IS (p = 0.001). Complication rate was low, 5.4% and 8.1% in the RBL and IS respectively and the difference was not statistically significant (p = 1.000). Conclusion: RBL and IS are equally effective and safe treatment modalities for the amelioration of symptoms of grades I – III haemorrhoidal disease, however grades II and III requires multiple treatment sessions to achieve symptom control. Both treatment modalities have similar complication rates and are thus recommended as a first line therapy in the management of grades I-III haemorrhoid.