Objective To investigate the feasibility of laparoscopic-assisted transanal everted pull-through resection and anastomosis in the treatment for ultra-low rectal cancer （the inferior margin of the tumor from the anal margin of less than 5cm）. Methods From December 2006 to December 2009，46 patients with ultra-low rectal cancer had been undergone laparoscopic-assisted transanal everted pull-through resection and anastomosis. The intraoperative condition，postoperative complications，and the result of follow-up were analyzed retrospectively. Results The operation was successfully performed on all the patients. The intraoperative blood loss was （202±56） ml （100-290m1）. The time of recovery of gastrointestinal function was （60±16） h （36-82 h）. No anastomotic bleeding or stomal leak was observed. All the patients were followed-up for （31±5） months （21-45months），15 patients developed mild to moderate anastomotic stricture，1 local recurrence， and 2 liver metastasis. All the patients had no anal incontinence 10months after stoma closure operation， the defecation of all the patients became normal （4.5±1.2） months（2-10months） later. Conclusions Laparoscopic-assisted transanal everted pull-through resection and anastomosis for ultra-low rectal cancer is safe and feasible， and the effect is satisfactory.