Gastrointestinal anastomosis is an important part of gastrointestinal operations and can be achieved by hand sewn anastomosis or by the newly developed staplers. The study aims to compare between the two surgical methods of anastomosis in a prospective , randomized design, regarding: operation time, post operative hospital stay and the incidence of post operative anastomotic leak in both groups. The study was carried out in Department of Surgery at Alsader Teaching Hospital in Basrah, Iraq from October 2015 to December 2016, it included 40 patients of both gender and with a different age, they divided into 2 groups (hand sewn and stapler groups), each group included 20 patients, comparing the following parameters: time of anastomosis, duration of surgery, post operative leak and hospital stay. There were no significant differences in the age, gender distribution, the indication for resection, post operative anastomotic leak (p=1) and hospital stay (P Value 0.15) in both group but there was significant differences in duration of anastomosis (P Value0 .00001) and operation time (P Value 0.00001). Our study concluded the superiority of stapler on hand sewing in gastrointestinal anastomosis in term of reducing operative time.