Abstract: Objective 　To compare local recurrence rate (LRR) and 52year livability of three different operations on low rectum cancer with or without anal sphincter preservation and to discuss the choice among them three. Methods 　The history of 254 patient s with low rectum cancer was collected and divided into three groups depending on the method of surgical t reatment . Study their LRR and 52year livability ret rospectively. Results 　Local excision group, 32 patients ; Dixon with Total Mesorectal Excision ( TME) group, 192 patients ; Miles with TME group, 30 patients. The total rate of anal sphincter preservation is 88. 2 %(224/ 254), and the LRR of tumor in group 1 is 15. 0 % with 5 recurrent cases in 2 years and 100 % 52year livability ; 16. 7 % in group 2 with 32 recurrent cases and 75. 5 % 52year livability, 20 % in group 3 with 6 recurrent cases and 47. 7 % 52year livability. There is no statistic difference between their LRR( P > 0. 05) . Conclusion 　We choose different operation method according to the size of the tumor, pathologic style and the Duke stage of the low rectum cancer. Operations with anal sphincter preservation were chosen in most cases. Miles is no longer the have-to-do operation on patient s with low rectum cancer.