Abstract: Objective To assess the feasibility,safety,and long term outcomes of laparoscopic surgery in obese patients with rectal cancer. Methods We retrospectively reviewed the data of 147 consecutive patients who underwent laparoscopic surgery for rectal cancer from October 2007 to December 2009.Patients were classified according to the categories proposed by the International Obesity Task Force,as Nonobese (body mass index［BMI］＜25.0 kg/m2),overweight (BMI 25.0~29.9 kg/m2),and obese (BMI≥30.0 kg/m2) groups.Surgical,oncologic,and long term results were compared among the patients in the nonobese,overweight and obese groups. Results Of the 147 patients,101,37,and 9 were classified as nonobese,overweight and obese groups,respectively.Clinicopathologic characteristics were similar among the three groups;while the comorbidity of patients in the overweight and obese groups were more than that in the nonobese groups(P=0.036).There were no differences among the groups in terms of complication rates,operative time,blood loss,distal margin for anterior resection or low anterior resection,and the number of the lymph node harvested(P>0.05). There was no significant differences in the conversion rate among the three groups(P=0.112),which was 4.0%,13.5% and 0 in the nonobese,obese and overweight groups,respectivtly.The median follow up was 24 months.The overall 3-year disease free survival was 74.2%,and the 3-year disease free survival of the patients in the nonobese,overweight and obese patients were 78.5%,55.7% and 100%,respectively (Log rank stastics=0.993,P=0.319). Conclusion Laparoscopic surgery of rectal cancer in overweight and obese patients is feasible and safe,and not affect the long term survival.