Abstract： Objective To evaluate the effect of total mesorectal excision with curved cutter stapler on low positioned rectal cancer(3～7 cm from anal verge)in the narrow pelvis.Methods Based on total mesorectal excision，30 cases of low rectal cancer in the narrow pelvis underwent sphincter preserving operation with curved cutter stapler.The 3 to 6 months follow-up result was retrospectively analyzed on radical resection effect，defecating function，complication rate and recurrent rate.Results All the resection margins were clear and the cases had no intraoperative death.Anastomotic stricture rate was 13.3％(4/30)，anastomotic leakage was 6.7％(2/30)，infection rate of incisional wound was 6.7％(2/30)， infection rate of cavitas pelvis was 3-3％(1/30) and no local recurrent case was observed.The function of patients anal sphincter was gradually recovered， and the defecation and sexual function recovered three months later.The micturition function recovered after 7 to 20 days (average 9 days).Conclusion Curability and anal function can be obtained by sphincter preserving operation.Curved cutter stapler is effective and safe for low rectal cancers in the narrow pelvis.