An elastic band ligation device for treatment of hemorrhoids including an inner tubular member for retaining a stretched elastic band over the front end thereof, a plunger in the inner tubular member with a handle for sliding the plunger to generate a suction for drawing hemorrhoidal tissue into the inner tubular member. An obturator connected to the plunger is provided within the inner tubular member. An outer tubular pusher sleeve with a limited friction fit is provided over the inner tubular member, the end of outer tubular pusher sleeve being adjacent the stretched elastic band. The outer pusher sleeve has a thumb pusher to allow the operator to push the outer pusher sleeve towards the front end of the inner tubular member or to secure the outer pusher sleeve and withdraw the inner tubular member, which deploys the elastic band on the hemorrhoidal tissue.