Hemorrhoids represent a common proctologic condition often requiring surgical management, particularly Grade IV. Thermofusion using the Ligasure™ device has emerged as an effective, minimally invasive technique ensuring precise hemostasis with limited thermal spread. We report the case of a 34-year-old male presenting rectal bleeding andanemia. Examination confirmed three internal Grade IV hemorrhoids. Thermofusion hemorrhoidectomy was performed under spinal anesthesia. The procedure achieved complete hemostasis, preserved sphincter integrity, and required no sutures. Postoperative recovery was uneventful, with same-day discharge and satisfactory healing at 3 weeks. Complete mucosal recovery occurred by 6 weeks. Thermofusion demonstrates a safe, efficient, and tissue-sparing alternative to conventional hemorrhoidectomy.