Abstract: Rectal cancer is one of the common digestive tract malignant tumors in China. In particular, middle and low rectal cancers are the most common. The treatment goal is to preserve anal function as much as possible through tumor radical resection. Owing to anatomical and biological explorations and the widespread application of new surgical equipment, the possibility of anal function-preserving anastomosis in low rectal cancer has gradually increased. This article reviews the research progress on anastomosis for low rectal cancer surgery and discusses its characteristics and operational difficulties.