To enhance thermal and overall performances, a novel microchannel heat sink (SSW-RP) was devised by integrating symmetric sinusoidal wavy sidewalls with rectangular rib prisms within the channels. A numerical comparative study was conducted to explore heat transfer mechanism in channels by investigating the flow and heat transfer characteristics of SSW-RP in comparison with those of smooth straight microchannel (MC), smooth straight microchannel with rectangular rib prisms (MC-RP), and symmetric sinusoidal wavy microchannel (SSW). The results show that the addition of rib prisms makes the fluid flow into wave peaks, reducing and even eliminating vortices from wave peaks of the symmetric sinusoidal wavy microchannel, thus significantly improving heat transfer performance. The new design SSW-RP had the highest relative Nusselt number, which reaches 4.16 at Re = 800. Further, the hydrothermal performance sensitivity of SSW-RP to the relative width (α) and length (β) of rib prisms is studied, and the best overall performance factor of SSW-RP finally can be achieved up to 1.88 at α = 0.35, β = 0.4 and Re = 800.