Objective This study aims at investigating the outcome of rubber band ligation of piles in an outpatient setting. Methods After taking an informed consent, 46 patients, 89% of them were males, mean age 52.5 years, with uncomplicated grade II-III piles were involved in the study. Rubber band ligation of piles was made by Pentax iScan gastroscope. The patients were followed up regularly to record any complication. Results Most of the patients (91.3%) need one session of treatment, 3 patients need 2 sessions, no more than 2 bands were used. Additionally, a relatively low percentage of patients recorded certain complication of the operation, on follow up. Conclusion High success rate, cost effectiveness and the simplicity of rubber band ligation as an outpatient procedure promote its use as the first line of treatment for first, second and early third degree hemorrhoids.