The incidence of rectal cancer is on the rise globally. The advancement of minimally invasive technologies has made surgical refinement a core clinical requirement. However, the complex pelvic anatomy means that the precision of surgical procedures directly impacts tumor radical cure outcomes and patients’ postoperative quality of life. Spearheaded by the Minimally Invasive Anatomy Group of the Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association, this consensus is based on anatomical principles. It interprets the anatomical theories of key structures such as the mesorectum and pelvic nerves, and clarifies the technical essentials and operational standards for minimally invasive surgeries. Targeted prevention and management strategies are provided for common postoperative complications. Additionally, the consensus looks ahead to the application prospects of new technologies including AI assistance and fluorescence imaging, offering practical references for clinicians. It aims to enhance the standardization and precision of minimally invasive anatomical surgery for rectal cancer in China, thereby better safeguarding patient prognosis.