With the development of surgical techniques, laparoscopic surgery has become a critical treatment for rectal cancer. Besides ensuring the radical removal of tumor to improve the prognosis, it's also important to reduce the surgical trauma, decrease the incidence of complications, improve the anal preservation rate, and accelerate the postoperative recovery. As a new technique, natural orifice specimen extraction surgery (NOSES) has the advantages of less trauma, faster recovery, and better cosmetic effect. In this article, we present a case of NOSES type IG for low rectal cancer, with the application of fluorescence navigation technology, intersphincteric resection and lateral lymph node dissection, giving consideration to the goals of radical removal, minimally invasive, and anus preservation.