Through literature review, this paper summarizes the understanding of hemorrhoids of the three major academic schools in the Ming and Qing dynasties (Zhengzong sect, Xinde sect and Quansheng sect). The etiology of hemorrhoids mainly includes four aspects: improper diet, abnormal change of emotions, sedentary weight bearing and excess of sexual intercourse. Chen Shigong (Zhengzong sect) attached great importance to the use of external treatment, advocating early diagnosis and treatment. Gao Bingjun (Xinde sect) paid great attention to internal therapy and did well in judging the prognosis by combining pulse diagnosis while protecting the healthy qi. Wang Weide (Quansheng sect) advocated the identification of cause according to syndrome differentiation, emphasizing that the protection of anus should be considered during the use of hemorrhoid-withering drugs.