ObjectiveTo evaluate the short-term clinical outcomes of transanal total mesorectal excision (TaTME) and provide evidence for clinical decision-making. MethodsRelevant literature from domestic and international databases in recent years was reviewed to systematically assess the current application of TaTME in the treatment of mid-to-low rectal cancer. A comparative analysis was conducted between TaTME and laparoscopic TME (LapTME), focusing on intraoperative outcomes, short-term postoperative recovery, intraoperative and postoperative complications, oncological prognosis, and the learning curve. ResultsConventional LapTME presents significant challenges in performing precise maneuvers within the pelvis and around the rectum, particularly in patients with "difficult pelvis" characteristics such as obesity, narrow pelvis, or male anatomy. In contrast, TaTME demonstrates certain advantages, including improved visualization of anatomical planes, reduced intraoperative bleeding, lower conversion rates to open surgery, faster short-term postoperative recovery, and enhanced specimen quality. ConclusionTaTME is a safe procedure with short-term outcomes that are superior or comparable to those of laparoscopic surgery, offering a new surgical option for the treatment of low rectal cancer.