Currently radical surgical resection is the only effective treatment for patients with rectal cancer. There are two major types of surgery, namely, anus-preserving surgery (Dixon surgery) and non-anus-preserving surgery (Miles surgery); there are open surgery and laparoscopic surgery. Laparoscopic surgery can be divided into completely laparoscopic surgery and laparoscopic-assisted surgery; the former has no abdominal incision, and the latter has a small abdominal incision. Open surgery, with a large abdominal incision, has the disadvantages of great trauma to the patient, slow postoperative recovery and many complications. Laparoscopic surgery, with a small abdominal incision, has the advantages of fine surgical operation, less interference with the gastrointestinal tract, clear vision, less bleeding, less intraoperative tumor extrusion, faster postoperative recovery, less postoperative intestinal adhesions and less postoperative pain. Rectum and its tumor are located in pelvic cavity, so it is difficult to operate open surgery due to small space and narrow field of view. However, the large laparoscopic field of view makes the anatomical structures easier to identify, easier to find the right tissue gap, easier to reveal the presacral nerve, seminal vesicles, vaginal rectal gap and prostatic rectal gap, which is conducive to reducing intraoperative injury and bleeding and protecting patients’ urinary function and sexual function. The extent of resection of lesions and lymph node clearance is the key to complete radical treatment of malignant tumors. Laparoscopic rectal cancer surgery can precisely ligate the blood vessels at the root of the mesentery, and the lymph nodes can be cleared more thoroughly; the surgery can perform a more delicate dissection of the presacral space under complete direct vision, and the rectal tumor and mesentery can be removed completely in strict accordance with the surgical principles of TME. The study showed that for patients with Dukes A and B stage rectal cancer, there was no difference in surgical outcome between the laparoscopic surgery group and the open surgery group, while for patients with Dukes C stage, the 5-year postoperative survival rate was significantly higher in the laparoscopic surgery group than in the open surgery group.