Laparoscopic technique has become an important minimally invasive platform for sphincter-preserving surgery of locally advanced low rectal cancer. This paper systematically reviews the advances in the application of laparoscopic techniques in total mesorectal excision, pelvic nerve preservation, distal resection margin management, and transanal combined approaches. Available high-quality randomized controlled trials have demonstrated that laparoscopic surgery is non-inferior to open surgery with regard to 5-year overall survival rate, disease-free survival rate and local recurrence rate. Its positive circumferential resection margin rate is controlled within 5% to 10%, and no significant difference is observed in the number of harvested lymph nodes.In terms of perioperative outcomes, the laparoscopic group achieves markedly reduced intraoperative blood loss (an average reduction of 50~100 ml), shortened postoperative hospital stay, and approximately 30%~50% lower wound infection rates. Nevertheless, its application remains challenging for special cases such as patients with a difficult pelvis (male gender, obesity, narrow pelvic cavity) and those with tissue fibrosis following neoadjuvant chemoradiotherapy. The conversion-to-laparotomy rate ranges from 5% to 15%. Moreover, the incidence of low anterior resection syndrome reaches as high as 60%~80%, and further prospective studies are required to verify its long-term functional preservation effects.