Laparoscopic anus-preserving surgery for ultra-low rectal cancer has become a routine operation in our department, enabling a large number of patients with low or even ultra-low rectal cancer to successfully preserve their anus under the premise of minimally invasive surgery! A 62-year-old female patient was admitted to the hospital for half a year due to increased stool frequency with bloody stool, and was diagnosed with rectal cancer after systematic examination (colonoscopy, transanal rectal mass pathology biopsy, pelvic MRI, etc.). During the operation, we used laparoscopic technique and standard TME technique to completely free the rectum and mesentery. In order to ensure the safe incision margin of the distal 2 cm, we dragged the rectum out of the anus and closed and cut the lower pole of the tumor at 2 cm (slightly above the dentate line) with a closure device under direct vision, and then completed the coloanal anastomosis to preserve the anus successfully. In this procedure, the use of laparoscopy facilitated the freeing of the low and especially ultra-low rectum, even between the sphincters, thus providing more chances for a safe 2-cm margin, and enabling successful anal preservation (both tumor eradication and anal preservation) in patients who were previously thought to be unable to preserve their anus.