Introduction:Bowel anastomosis are common procedures in both elective as well as emergency gastrointestinal surgeries. The anastomosis technique in emergency and elective procedures depends on site, bowel calibre and underlying disease. The advent of mechanical stapling devices hasrevolutionised the field of gastro-intestinal surgery in the recent times. However, universal availability, surgeon familiarity and trust as well as the cost factor are limiting factors to their use. The present study aims to evaluate the stapler anastomosis and traditional hand sewn technique with respect to their perioperative outcomes. Material and Methods:100 patients who required intestinal anastomosis were included in the study. These patients were randomised into two groups- H(hand sewn) and Group S (stapler anastomosis) with 40 patients each. In group H, intestinal anastomosis was done using the classical double layer techniquewhilst in group S, anastomosis was done using mechanical stapling devices. A comparison was made between both the groups in terms of per- operative and post-operative outcomes i.e., time taken for anastomosis, incidence of anastomotic leak, return of bowel activity and restoration of enteral feeds and rates of other complications such as paralytic ileus and wound infection. Results:The most significant difference was in the mean duration required for hand sewn anastomosis in comparison to stapler use (26.14 + 4.52 mins vs 5.57 + 2.31). Lesser bowel handling and operative time meant earlier return of bowel activity (2.39 + 0.74 vs 3.35 + 1.09 days) and restoration of oral feeds in stapler group. In terms of postoperative leak and other complications, hand sewn intestinal anastomosis offered no definite advantage over the stapler anastomosis with similar outcomes observed. Conclusion:Considering the duration of procedure and ease of completion, use of mechanical staplers for intestinal anastomosis may prove the optimal choice in most gastro-surgical situations.