Abstract: Objective To compare the efficacy and safety of laparoscopic and open rectal cancer surgery in the treatment of rectal cancer. Methods Total 60 cases of rectal cancer in our hospital between May, 2009 and December, 2016 were enrolled and divided into conventional open surgery group (group A) and laparoscopic group (group B) according to the operation mode with 30 cases in each group. The conventional open resection was performed in the group A, while laparoscopic resection was performed in the group B. The intraoperative conditions, time to first flatus, duration of indwelling urinary catheter, and the incidence of postoperative complications were documented; The patients was followed to observe the five-year survival rate. Results The duration of hospital stays in group B was shorter than that in group A, while the time to ambulation, time to first flatus, duration of indwelling urinary catheter, and postoperative time to feeding liquid diets in group A were all shorter than in group B. The surgical incision in group B was smaller than that in the group A, and the pain score in group B was lower than that in group A. However, the hospital expenses and operation duration in group B excessed those in group A. There was significant difference in the short term efficacy between the two groups (P < 0. 05).The incidence of complication was 33. 33% in the group A and 10. 00% in the group B, the difference was significant (P < 0. 05). Conclusion The therapeutic effects of laparoscopic rectal cancer surgery for rectal cancer was remarkable, with a better short-term outcome, higher radical rate, less operation time, quick postoperative recovery, early postoperative ambulation, lower incidence of complications and higher safety.