【Abstract】 Objective The aim of the current study was to evaluate the clinical feasibility and safety of transanal total mesorectal excision for distal rectal carcinoma. Methods Clinical data of twentytwo patients(8males and 14females) with low rectal cancer underwent the transanal total mesorectal excision in our department from January 2015 to December 2016 were retrospectively analyzed.Results The surgery was smoothly completed for all the patients in this studying group, with no conversion to open surgery. The mean age was 637±126 years, the mean body mass index was 234±25 kg/m2,and the tumor's mean distance from the anal verge was 49±12cm. The median operating time was 2725 minutes (range, 125375 minutes),and the median estimated blood loss was 40mL (range,10300 mL).The macroscopic quality assessment of the resected specimen was complete in 864%,nearly complete in 136%, the circumferential resection margin positivity rate was 45%,the median distal margin was18 cm (054),and the median number of harvested lymph nodes was 14(737).Intraoperative morbidity occurred in 45% and the postoperative morbidity rate was 273%. Conclusion TaTME appears to be an oncologically safe and effective technique for distal mesorectal dissection with pathological outcomes and morbidity profile.