Hemorrhoids are common in patients with acquired immunodeficiency syndrome. Very limited data are available to provide evidence-based support for the treatment of patients with hemorrhoids combined with immunodeficiency. For patients with hemorrhoids combined with immunodeficiency, conservative treatment is generally recommended as the first choice; when conservative treatment is ineffective, instrumental treatment is recommended; and when none of these methods are effective, surgical treatment may be considered. How to treat patients with combined immunodeficiency hemorrhoids? Conservative treatment: Conservative treatment considered are dietary modification, sitz bath, magnetic therapy, drug therapy and so on. Dietary modification, including the intake of adequate fluids and dietary fiber, as well as the formation of good fecal habits, is important for the prevention of hemorrhoids and the non-surgical treatment of hemorrhoids. Sitz baths are a traditional treatment for hemorrhoids, but there is a lack of randomized controlled trials to confirm the role of warm water sitz baths in the treatment of hemorrhoid-related symptoms, and there are no studies to demonstrate the optimal sitz bath temperature, duration, and type of sitz bath. In recent years, magnetic therapy has also been recommended by clinicians for the relief of symptoms of acute hemorrhoidal flare-ups or the treatment of edema and pain after hemorrhoidal surgery, which can correct tissue ischemia and hypoxia, promote the absorption of exudate and eliminate inflammation. Drug therapy also has a certain improvement effect on hemorrhoids. Oral fiber-based laxatives have a good therapeutic effect on hemorrhoidal patients, which can relieve hemorrhoidal symptoms and reduce bleeding; non-steroidal anti-inflammatory drugs are one of the commonly used analgesics, which are generally used in the clinic for postoperative analgesia in hemorrhoidal patients. In addition, topical medications containing aluminum sulfate can improve wound healing by providing a protective barrier to the wound, thus reducing acute pain after hemorrhoidal instrumental therapy or surgery, accelerating wound recovery, and reducing the use of analgesics. Instrumental treatment: For patients with internal hemorrhoids of degree I to III who have failed to undergo conservative treatment and for patients with internal hemorrhoids of degree IV who are unwilling to undergo surgical treatment or have contraindications to surgery, the use of rubber-band ligation (RBL) is recommended, and injectable therapies may also be considered. RBL is superior to sclerotherapy for patients with internal hemorrhoids of degree I to III. Patients treated with RBL are less likely to require further treatment than those treated with sclerotherapy and infrared therapy, but are more likely to experience pain after RBL. The next choice is injection therapy, which is administered by injecting drugs into the hemorrhoidal tissues and surrounding tissues, thereby inducing hemorrhoidal vascular occlusion, tissue fibrosis and causing hemorrhoidal tissues to shrink and bleeding to stop, etc., such as antipilespiridol, peonybeam, dextrose solution, and sodium chloride solution. Surgery: Surgery can be considered for patients with Ⅰ~Ⅲ hemorrhoids who have not achieved acceptable results with conservative treatment and/or instrumental treatment, or patients with Ⅳ degree hemorrhoids who are willing to undergo surgical treatment. Hemorrhoidectomy is suitable for patients with Ⅲ~Ⅳdegree internal hemorrhoids, external hemorrhoids or mixed hemorrhoids combined with prolapsed hemorrhoids; anastomotic hemorrhoidectomy and fixation is suitable for Ⅲ~Ⅳdegree internal hemorrhoids with annular prolapsed hemorrhoids and Ⅱdegree internal hemorrhoids with recurrent bleeding; transanal hemorrhoidal artery ligation is suitable for patients with Ⅱ~Ⅲdegree internal hemorrhoids. Are there risks associated with interventions in hemorrhoidal patients with comorbid immunodeficiencies? It is important to note that any intervention increases the risk of anorectal sepsis and poor tissue healing in immunodeficient patients. For patients with hemorrhoids combined with immunodeficiency, there is no evidence to prove which treatment is best, and more randomized controlled trials are needed to provide higher quality scientific evidence. What is certain, however, is that antibiotics should be taken for prophylaxis before any intervention. REFERENCES [1] Chinese Society of Integrative Medicine, Colorectal and Anal Disease Specialized Committee. Chinese hemorrhoid diagnosis and treatment guidelines (2020)[J]. Colorectal and Anal Surgery,2020,26(5):519-533.