Milligan and Morgan and Arnous anoplasty procedures are described; their indications come from pathological features and associate pathology. Left internal sphincterotomy and posterior sphincterotomy and anoplasty are described and discussed on the basis of the Author experience about 523 haemorrhoidectomies. Internal sphincterotomy, when indicated, avoids pain, urinary retention, fissure and stenosis. Early and late complications are evaluated for both the procedures.