Transanal total mesorectal excision (taTME) is a novel approach to radical resection for mid or low rectal cancer. Compared with conventional laparoscopic TME (lapTME), taTME is relevant to the benefits of better vision of the distal mesorectal plane, feasibility of operating in a narrow pelvis, and exact definition of distal resection margin, which may lead to a higher possibility of free circumferential resection margin, better quality of TME specimen, and lower hurting rate. This article reviews and analyzes the short-term and long-term outcomes of taTME and the related progress of postoperative function. The results showed that there were no significant differences in the main short-term and long-term efficacy between taTME and lapTME, but taTME had potential advantages in postoperative functional recovery.