Synchronous colorectal cancer (SCRC) and natural orifice specimen extraction surgery have been the focus of attention. SCRC is complex, difficult to treat and has many surgical methods. In recent years, the curative effect of multi-center NOSES is also affirmed. Among them, the right colon cancer NOSES surgery or rectal cancer NOSES surgery has been included in the expert consensus of colorectal cancer through natural orifice specimen extraction surgery, and the safety has also been affirmed, while the right colon combined with rectal cancer NOSES surgery has rarely been reported. The right colon combined with median rectal cancer radical resection without auxiliary incision was successfully performed in our hospital recently, aiming to explore a new surgical treatment for SCRC.