Objective To analyze the effects of low ligation of inferior mesenteric artery (IMA) combined with D3 lymph node dissection and high ligation in the treatment of rectal cancer and the influence on survival time. Methods The clinical data of 95 rectal cancer patients receiving surgical treatment were retrospectively analyzed. According to the surgical method, they were divided into low ligation group and high ligation group. The former received low ligation of IMA combined with D3 lymph node dissection, while the latter received high ligation. The surgery, postoperative body recovery, outcomes of lymph node dissection, postoperative complications and survival were compared between the two groups. Results The operation time of low ligation group was longer than that of high ligation group (P＜0.05), and postoperative ventilation time was shorter than that of high ligation group (P＜0.05). There were no significant differences in intraoperative blood loss, hospital stay, the number of lymph nodes removed by D3 lymph node dissection and the total number of lymph node removed between the two groups (P＞0.05). The incidence of anastomotic leakage in low ligation group was lower than that in high ligation group (P＜0.05), but there was no significant difference in the incidence of other complications between the two groups (P＞0.05). There were no significant differences in tumor recurrence rate and postoperative 3-year cumulative survival rate between the two groups (P＞0.05). Conclusion Low ligation of IMA combined with D3 lymph node dissection can achieve similar effects and postoperative 3-year cumulative survival rate in the treatment of rectal cancer. However, the former can better reduce the occurrence of anastomotic leakage.