Introduction: Hemorrhoidectomy is one of the most common surgical procedures, and other treatments such as laser hemorrhoidectomy had been used as an alternative. The aim of this study was to determine the outcome and postoperation complications of treatment by laser compared with open hemorrhoidectomy. Materials and methods: In this randomized clinical trial (RCT), 85 cases with a second or third degree of hemorrhoids were assigned to two groups at random and followed for 6 months. Those patients in the intervention group were treated by laser hemorrhoidoplasty (LHP) and those in the control group underwent Milligan and Morgan hemorrhoidectomy. At the end of follow-up, 80 cases remained in the trial on whom postoperative pain [visual analog scale (VAS)], complications, and quality of life according to the 36-item Short Form Health Survey (SF-36) questionnaire were studied. Data were analyzed using R 3.5.1 software and p value <0.05 was considered significant. Results: The most common complaints were bleeding (57%) and pain (41%). Postoperative pain immediately and after 6 months was not significantly different between the two groups (p > 0.05). No complications were seen in any groups in follow-up. All eight scales of SF-36 questionnaire, except general health, were significantly different in the two groups. Physical functioning was lower in patients who underwent LHP, whereas the patients’ quality of life in other scales was better in the laser group. The total score of SF-36 was 66.1 ± 3.6 and 56.0 ± 3.3 in laser and surgery groups, respectively (p < 0.001). Conclusion: Laser hemorrhoidectomy is a safe procedure, not associated with any excessive postoperative complications. It improves patients’ quality of life and can be a substitution of other surgical methods.