Background: Hemorrhoidal disease is a common anorectal disorder, with Grade III internal hemorrhoids often requiring procedural intervention. (MRBL) and (MMH) are two widely used techniques for treatment. While MMH is a definitive surgical option, MRBL has emerged as a minimally invasive alternative with promising outcomes. A comparative evaluation of these procedures is essential to determine their efficacy, safety, and patient satisfaction. Aim: The purpose of this study was to compare the functional and surgical results of MMH and MRBL in patients with Grade III internal hemorrhoids, with an emphasis on postoperative discomfort, complications, recurrence rates, and overall patient satisfaction. Methods: At the Narayan Medical College & Hospital, a prospective, single-center, double-blind randomized controlled experiment was carried out. Two groups of sixty patients with Grade III hemorrhoids were randomly assigned: MRBL (n = 30) and MMH (n = 30). Patient satisfaction, recurrence rates, postoperative complications, baseline characteristics, and intraoperative parameters were evaluated. Statistical analysis was performed using SPSS version 21.0, with a p-value < 0.05 considered significant. Results: MRBL showed a significantly lower blood loss (15.4 ± 3.8 mL vs. 32.5 ± 7.4 mL, p < 0.001) and a significantly shorter operating time (18.6 ± 4.2 min vs. 34.2 ± 6.1 min, p < 0.001) than MMH. The MRBL group experienced a shorter hospital stay (1.2 ± 0.5 days vs. 3.5 ± 1.2 days, p < 0.001) and significantly lower postoperative pain scores (VAS scale) (2.8 ± 1.1 vs. 6.5 ± 1.4, p < 0.001). Patient satisfaction was similar in both groups (p = 0.56), despite the MRBL group having a significantly higher recurrence rate at 6 months (13.3% vs. 6.7%, p = 0.39). Conclusion: MRBL was found to be a less intrusive, safe, and effective substitute for MMH, resulting in shorter hospital stays, quicker recovery, and less postoperative pain. The MRBL group had somewhat higher recurrence rates, but the difference was not statistically significant. Recommendations For Grade III hemorrhoids, MRBL can be regarded as a first-line treatment, especially in outpatient settings where less intervention and a quicker recovery are preferred. Further long-term studies are recommended to assess recurrence patterns and optimize treatment protocols.