Objective To summarize the clinical effect and the key part of operation of procedure for prolapse and hemorrhoids (PPH) in treatment for severe mixed hemorrhoids or circular hemorrhoids. Method The data of 183 patients with severe mixed hemorrhoids or circular hemorrhoids underwent PPH in this hospital from August 2006 to November 2012 were analyzed retrospectively. Results The operation time was (28.5±3.1) min. The operations were successfully completed at one-stage in all the patients. The average hospital stay was 5.2 d. No postoperative bleeding, fecal incontinence, and infection happened. No recurrence and complications such as postoperative rebleeding,anal stenosis, fecal incontinence, etc were found during 1 month to 3 years of follow-up with an average 26 months. Conclusions PPH as a minimally invasive operation, every detail of it should be well performed in order to improve the clinical treatment effect and reduce complications of the patients with severe mixed hemorrhoids or circular hemorrhoids.