Abstract: Objective To compare the perioperative indexes and long-term complications of laparoscopic low anterior rectal resection(LAR) and abdominalperineal resection(APR) in treatment of rectal cancer. Methods A retrospective analysis was performed on 168 cases who underwent laparoscopic radical resection in general surgery department of the first medical center of Chinese PLA General Hospital from January 2014 to June 2018, among which 122 cases were in the LAR group and 46 cases in the APR group. The operative time, intraoperative blood loss, changes of perioperative inflammatory indicators such as white blood cell count, neutrophil percentage, lymphocyte percentage and neutrophil to lymphocyte ratio(NLR), short-term and long-term complications were compared. Results There was no statistically significant difference between two groups in age, gender, tumor volume, tumor T stage, preoperative albumin level, preoperative hemoglobin level and other baseline characteristics(P> 0.05). Both the two groups showed increased WBC count, increased neutrophil percentage, decreased lymphocyte percentage, and increased NLR, but the differences between two groups were not statistically significant(P> 0.05). The operative time (175.3±60.8) min vs(225.1±58.7) min and intraoperative blood loss 50(50, 100) ml vs 100(50, 200) ml in the LAR group were significantly less than those in the APR group, but the incidence of postoperative long-term complications(25.4% vs 6.5%) was significantly higher than that in the APR group, with statistically significant differences(all P< 0.05). Conclusion In terms of perioperative indicators and postoperative complications, laparoscopic LAR and APR have their own advantages. Both of them cause the same trend of changes in perioperative inflammatory indicators. LAR is superior to APR in both operative time and intraoperative blood loss, but has higher incidence of long-term postoperative complications.