Objectives: Hemorrhoids are among the most common complaints worldwide, ranging from painless rectal bleeding to prolapsed hemorrhoids. Hemorrhoids can be classified into external and internal types. External hemorrhoids do not need any specific treatment unless they are cause pain, bleed or become thrombosed.
 Methods: This study is a prospective study (case series study), approved by ethical committee, conducted on Fifty patients with prolapsed pile, 46 of whom were males and 4 were females and were collected in the span of 2 years from Sulaymaniyah Teaching hospital and Shar hospital. Topical application of mannitol included a gauze soaked with mannitol solution and applied to the prolapsed hemorrhoids.
 Results: All the patients presented with prolapsed hemorrhoids, 46 of them were males and 4 of them were females. Most of patients were heavy workers (46%), while students made up (18%), employee (22%), retired (8%) and free workers (6%). The most common clinical presentations were constipation (72%), anal pain (68%), bleeding (50%), itching (14%), discharge (4%) and prolapse only (6%).
 Conclusions: Prolapsed hemorrhoid can be managed conservatively by topical application of mannitol as it decreases edema, causing the hemorrhoidal tissue to retract to its position.