Background: In young women undergoing radiation therapy for pelvic or low abdominal cancers, ovarian failure is a major concern and every attempt should be made to avoid it. This article describes a case of a young female patient with rectal adenocarcinoma who underwent laparoscopic bilateral ovarian transposition prior to pelvic radiation and chemotherapy. Case: A 27-year-old female presented with abdominal pain, diarrhea, and intermittent rectal bleeding of 2 months' duration. Colonoscopy revealed a large frondlike/villous, fungating, ulcerated, nonobstructing mass that was suspicious for malignancy. Biopsy confirmed moderately differentiated rectal adenocarcinoma. The patient elected to undergo laparoscopic ovarian transposition in an attempt to preserve her ovarian function. Subsequently, the patient underwent robotic low anterior resection of the rectum. Results: The patient's regular menstruation resumed after surgery, and she has not had any symptoms of ovarian failure or cancer recurrence 2 years after surgery. Conclusions: In premenopausal women with pelvic cancers undergoing pelvic radiation, laparoscopic ovarian transposition is a feasible, safe procedure that should be considered to decrease the risk of ovarian failure. (J GYNECOL SURG XXXX:1) [ABSTRACT FROM AUTHOR]