Total mesorectal excision (TME) is the standard surgical treatment for rectal cancer. Studies suggest that compared with open resection, laparoscopic TME provides similar oncologic outcomes while reducing hospital stay, minimizing recovery time, and improving cosmesis. The smaller abdominal incisions may also decrease the risk of wound infections and incisional hernia formation. In fact, the laparoscopic technique facilitates the surgical process by allowing for increased maneuverability and enhanced visualization within the surgical field of the pelvis. In this chapter, we focus on the major elements of laparoscopic low anterior resection and TME, highlighting the capability of achieving a laparoscopic approach to produce a favorable oncologic outcome.