Abstract: The incidence of low rectal cancer, which severely threatens human health, has been increasing annually in China. Surgical operation is the most effective treatment for low rectal cancer. In-depth analyses on the physiology and anatomy of the rectum and the biological characteristics of low rectal cancer have led to the wide application of anus preservation operation as a treatment for this disease. Anus preservation operation is widely used, especially because the application of the laparoscopic technique has recently become a popular topic in colorectal surgery. Alternative laparoscopic sphincter-preserving procedures for this disease include the following: laparoscopic anterior resection; and laparoscopic anterior resection with inter-sphincter resection or with prolapse technique. Colorectal anastomosis with double-stapler technique, hand-sewn coloanal anastomosis, and colonic J-pouch-anal anastomosis are common reconstruction procedures. Each procedure has its own adaptive range, advantages, and disadvantages. Radical surgery must be prioritized, but we should also consider the patients' life quality when selecting a mode of surgery.