Laparoscopic surgery has been widely utilized in the treatment of rectal cancer. Considering the predominance of low and ultra-low rectal cancer in China，the rational selection of surgical approaches to achieve both tumor eradication and functional preservation is a clinically significant issue that warrants in-depth investigation. There is a wide range of laparoscopic techniques available for low rectal cancer，necessitating careful preoperative evaluation and precise determination of indications for neoadjuvant therapy. The fundamental objective should be achieving oncological clearance while ensuring appropriate selection of sphincter-preserving procedures. The choice of surgical approach should be personalized according to individual patient characteristics.