Background and Aims Internal haemorrhoids are common causes of rectal bleeding. When haemorrhage severely impacts patients' quality of life or is even life-threatening, and surgery cannot be performed due to contraindications or the patients are unwilling to undergo the operation, superselective superior rectal artery (SRA) angiography and embolization are one of the best options for rapid haemostasis. Interventional endovascular haemostasis has the characteristics of minimally invasive, fast recovery, and fewer postoperative complications than traditional surgical procedures. However, there are few reports on the application of superselective SRA embolization in rectal bleeding caused by internal haemorrhoids in our country, and its haemostatic effect and safety are still controversial. This study was conducted to evaluate the safety and efficacy of transcatheter super-selective SRA embolization in the treatment of rectal haemorrhage and discuss the technical points and cautions that may influence clinical outcomes, and provide references for clinical practice.Methods The clinical data of all rectal bleeding patients who underwent super-selective SRA embolization at Binzhou Medical University Hospital between December 2016 and October 2021 were retrospectively analysed. The haemostatic effect and postoperative complications of 3-7 d (initial haemostatic rate) and 1-12 months (clinical success rate) after SRA embolization were observed and analysed.Results A total of 50 patients with rectal bleeding successfully underwent superselective SRA embolization, and only 29 patients were included in the final analysis according to the inclusion and exclusion criteria. Among them, 11 patients had grade Ⅱ internal haemorrhoids, and 18 had grade Ⅲ internal haemorrhoids; 17 patients were males, and 12 were females, with a mean age of (51.8±12.2) years. All patients underwent SRA embolization with metal coils (2-3 mm) combined with gelatine sponge particles (350-560 μm) or PVA particles (300-500 μm), and the technical success rate was 100%. Bleeding control or clinical success rate was achieved in 82.8% (24/29) of patients at day 3 to 7 and 86.2% (25/29) at one month postoperatively. Recurrent bleeding occurred in 3 patients (3/25) at 6 months follow-up, and the clinical success rate was 75.9% (22/29) at 6 months postoperatively; two of the three patients underwent internal iliac branches embolization and the symptoms dissipated, while one with conservative management. All patients were followed up for (10.7±2.5) months. In one patient who presented with obvious tenesmus, a colonoscopy revealed a small piece of superficial ulcer on the rectum in the first week after the operation, and conservative management was performed. Two patients had hematoma at the puncture site, which disappeared after conservative treatment. Other patients noted no severe complications, such as infection, intestinal perforation, or massive haemorrhage related to interventional embolization.Conclusion Super-selective SRA embolization is a relatively safe and low-risk surgical method in treating rectal bleeding caused by grade Ⅱ-Ⅲ internal haemorrhoids. It has positive short-term efficacy, especially in an emergency setting. This method has a satisfactory practical application and is worth being recommended.