Background: Hemorrhoids are one of the most common anorectal conditions frequently encountered in surgical department. There are various non-surgical and surgical treatment modalities to manage hemorrhoids. The present study was conducted to compare the treatment outcome of sclerotherapy and open hemorrhoidectomy in second degree hemorrhoids. Methods: This comparative study was conducted in Department of General Surgery, Adesh Medical College and Hospital, Shahbad. 80 patients of second degree hemorrhoids were enrolled in the study and they were subjected to either sclerotherapy or open hemorrhoidectomy. Results were expressed as mean ± standard deviation. Results: The duration of procedure was 10.64 ± 3.94 minutes in sclerotherapy group and 44.87 ± 6.24 minutes in open hemorrhoidectomy group, with statistically highly significant difference (p<0.0001). The hospital stay was significantly shorter in sclerotherapy group compared to open hemorrhoidectomy group (0.4 ± 0.1 days vs 1.6 ± 0.2 days; p<0.0001). Cure rate was 85% in sclerotherapy group and 100% in open hemorrhoidectomy group with statistically significant difference (p<0.05). Conclusion: Sclerotherapy is non-surgical treatment modality with shorter hospital stay and fewer complications whereas open hemorrhoidectomy is a definitive treatment with higher cure rate.