Objective: To study the risk factors and strategies of sphincter-preserving surgery after laparoscopic rectal cancer for reference. Methods: 80 patients who underwent laparoscopic rectal cancer from January 1, 2015 to December 31, 2016 were the subjects of this study, and the detailed analysis of 80 patients was retrospectively analyzed. The occurrence of anastomotic fistula and the number of patients did not occur into the ratio. Results: The results showed that anastomotic fistula occurred and the body weight index did not occur, preoperative albumin and other significant differences, p < 0.05. Conclusion: The risk factors of anastomotic fistula include body mass index, preoperative albumin and so on. It is effective to reduce the incidence of anastomotic fistula in patients with risk factors.