Objective To analyze the effect of layered surgical treatment on postoperative edema and anal function in patients with complex mixed hemorrhoids. Methods A total of 200 patients with complex mixed hemorrhoids admitted from January 2022 to March 2025 were selected and divided into two groups based on their surgical methods. Patients who underwent traditional external dissection and internal ligation surgery were selected as the control group （n=100）, while patients who underwent layered surgery were selected as the observation group （n=100）. Clinical efficacy, postoperative pain and rectal bleeding scores, postoperative edema, and improvement of anal function were compared between the two groups of patients. Results There was no statistically significant difference in therapeutic efficacy between the two groups （P>0.05）. Compared with the control group, the observation group had significantly lower postoperative pain scores and postoperative rectal bleeding scores （P<0.05）. On postoperative day 3 and 5, the observation group showed significantly lower levels of edema compared to the control group （P<0.05）. Three months after surgery, there was no significant difference in anal function indicators between the two groups （P>0.05）. Conclusion Although the layered surgical treatment for complex mixed hemorrhoids is comparable in efficacy to traditional external stripping and internal ligation surgery, it can significantly reduce postoperative pain and rectal bleeding in patients, and effectively reduce the degree of edema in the middle and late postoperative periods without significant adverse effects on anal function.