Objective To study the efficacy and its influence on anal function of RPH combined with external ligation and internal ligation in the treatment of severe mixed hemorrhoids. Methods 100 patients with severe mixed hemorrhoids admitted to our hospital from May 2017 to May 2018 were selected as research subjects. They were randomly divided into the study group and the control group, 50 cases in each group. The control group was treated with PPH, and the study group was treated with RPH combined with external stripping and internal ligation. The therapeutic effect and operation related indexes of the two groups were compared, and the postoperative anal function scores were observed. Results The clinical efficacy of the study group was higher than that of the control group (P<0.05), and the intraoperative bleeding volume, operation time and hospitalization time of the study group were lower than that of the control group (P<0.05). The anal function scores such as dry stool, gas, dilution, lifestyle changes and padding requirement in the study group were lower than those in the control group (P<0.05). Conclusion RPH combined with external stripping and internal ligation is better than PPH alone in the treatment of severe mixed hemorrhoids.