Although laparoscopic proctocolectomy has been widely performed around the world, there is still controversy regarding the use of laparoscopy for rectal cancer treatment. Physicians who have reservations about laparoscopic rectal cancer surgery are mainly motivated by two considerations: first, unlike laparoscopic colon cancer surgery, the long-term safety and curative effect of laparoscopic rectal cancer surgery are still not fully proven. So far, only a few multicenter prospective clinical randomized controlled trial (RCT) studies have reported the results, while others are still in progress. Second, rectal cancer surgery is more technically demanding than colon surgery. This is mainly determined by the complexity of TME surgery: the bony structure of the pelvis makes the anatomical exposure around the rectum difficult; and the requirement to obtain appropriate margins during TME surgery to avoid recurrence. In addition, the surgeon needs to try not to damage the sphincter and to preserve sexual and urinary function. In other words, there are so many factors to consider when choosing laparoscopic surgery for rectal cancer, including the challenge of the technique, feasibility, functional preservation, and the radicality of the tumor. However, with the improvement of laparoscopic surgical instruments and equipment, the improvement and standardization of surgeons’ surgical skills, the understanding of laparoscopic surgery complications and targeted prevention, the advantages of laparoscopic surgery for the treatment of rectal cancer have gradually emerged, and this surgery has gradually been accepted by most surgeons and become one of the most mature surgical procedures in laparoscopic gastrointestinal tumor surgery.