Objective To Summary the clinical experience of prolapse and hemorrhoid (PPH) combined with external hemorrhoid resection in the treatment of severe mixed hemorrhoids. Methods Retrospective analysis of clinical data of 51 patients with severe mixed hemorrhoids. Result The anal forms were changed correctly without complications such as postoperative hematochezia、postoperative recurrence, incontinence, anal stenosis, postoperative massive bleeding、infection and pain. Conclusion PPH combined with external hemorrhoid resection is a safe and effective method for severe mixed hemorrhoid, which can decrease complications and improve effect .