Rectal cancer is one of the most common gastrointinal malignant tumors, and mid-low rectal cancer is more common in China. For low rectal cancers from the anus less than 5 cm, conventional abdominoperineal resection (APR) has not only complicated surgical trauma, but also the coloproctia brings great pain to the patient. In recent years, with the deeper understanding of the characteristics of rectal cancer, the application of neoadjuvant and the development of surgical instruments and technic, on the basis of radical tumor resection, the anastomosis has been continuously challenged to a lower position. Functional protection and improved quality of life have become important targets for the treatment of low rectal cancer. The intersphincteric resection (ISR) has brought more opportunities for preserving the sphincter function in some patients with low rectal cancer. Its oncological outcomes and anal function are acceptable. The purpose of this paper was to review the status and progress of ISR, evaluate current evidence regarding oncological and functional outcomes after ISR for low rectal cancer.