BACKGROUND:. The hand-sewn bowel anastomosis may be performed as a single layer suturing technique or double-layer technique of anastomosis. The most scientific way to conclude the superiority of one method over others is evidence-based medicine. Hence, we conducted a retrospective study in our institute to compare single- layer interrupted extra mucosal intestinal anastomosis with a double-layer conventional method of intestinal anastomosis. METHODS: Retrospective, Comparative study on 53 patients, who underwent intestinal anastomosis, from August2019 to July 2022. Patients were allotted into two groups. single-layer anastomosis were grouped under Group A, and double-layer anastomosis were grouped under Group B. Outcomes were analyzed in terms of time taken for anastomoses, hospital stays, cost-effectiveness and complications. RESULTS: The mean age in group A was 41.4 years, and in group B was 41.25 years. Both males and females were equally affected. The ileal stricture was seen in 12 (23.07%) cases; and resection of ileum and ileo-ileal anastomosis was performed in the maximum number of cases. In group A mean duration to perform singlelayer anastomosis was 19.04 minutes and 28.8 minutes in Group B. The mean differ between two groups was 9.76 minutes, and the P-value was <0.001, which is highly significant. An overall complication in the form of anastomotic leak was noted in 7 patients (13.4%) including both A and B group; 2 (3.8%) cases in Group A and 5 (9.6%) in Group B and the difference was statistically significant. The mean duration of hospital stay in Group A was 7.32 days and Group B was 7.92 days (difference was statistically insignificant). CONCLUSION: Single layer interrupted extra mucosal intestinal anastomosis is a better procedure when compared to continuous double layer conventional method of intestinal anastomosis as it takes less time for construction, cost effective and has low risk of developing complications.