The use of laparoscopic techniques in the treatment of rectal cancer was until recently regarded with skepticism, because it did not seem to fulfill the oncologic principles of open surgery. The first report of a rectal cancer case treated by using laparoscopy has been made approximately two decades ago. From that moment on, the laparoscopic technique, progressed thanks to the development of the optical devices that allowed the improvement of the laparoscopic image, as well as the progressive increase of experience of the surgical teams specialized in colorectal laparoscopic surgery. These advantages (the faster recovery of the bowel function, less postoperative pain, lower blood loss, decreased hospitalization period) make the laparoscopic surgery a viable option for the treatment of rectal cancer. Recently published studies prove the similar results between open surgery and laparoscopic surgery for rectal cancer, in terms of mortality and postoperative morbidity, local recurrence, long–term survival or postoperative complications (anastomotic fistulas, bladder dysfunction, and sexual dysfunction), some studies even revealing the superiority of the laparoscopic surgery in preserving the function of the pelvic nerves.