Abstract: Using laparoscopic assisted surgery in management of rectal cancer, particularly, very low rectal cancer is still complicated due to technical difficulties owing to its anatomical location in the pelvis. Moreover, the approach of laparoscopic assisted intersphincteric resection as a recent management strategy of very low rectal cancer remains a controversial issue, due to few prospective studies about such issue, advantages, benefits and contraindications of such procedure is still not reaching a consensus. Aim of the present case study to evaluate both the short-and long-term surgical results of laparoscopic intersphincteric resection as a management surgical approach of low rectal cancer comparing such procedure with open intersphincteric resection. Patients and methods: we selected 90 patients with low rectal cancer, 60 patients underwent laparoscopic assisted intersphincteric resection and 30 patients underwent open intersphincteric resection. We compare between both groups regarding short and long term outcomes. Results: In the group of patients who were managed by laparoscopic approach the median time of surgery was significantly longer than the open approach (p=0.002) but the median amount of intra-operative blood loss and the median duration of post-operative hospital stay were significantly less than the open approach (p =0.011 and 0.043).In the group of patients who were managed by laparoscopic approach there is reduction of morbidity and complications which indicated a safe outcome of such procedure. Conclusions: laparoscopic approach has many advantages that it leads to less amount of intra-operative blood loss, a shorter duration of staying at hospital, less post-operative morbidity, less short term and long term complications than the open approach. Keywords: low rectal cancer, intersphincteric resection, laparoscopic, open