Objective To summarize the experience and feasibility of three?dimensional(3D) rotatable laparoscopic anterior resection for rectal cancer and compare with two?dimensional(2D)lapa? roscopy. Methods We retrospectively analyzed 86 cases(from Oct. 2014 to Sep. 2016)of rectal cancer for laparoscopy(40 cases for 3D group and 46 cases for 2D group). We compared the mean of operation duration, intraoperative blood loss, postoperative exhaust time, postoperative hospital stay, number of lymph node dissection between two groups. Results All cases were performed with laparoscopic procedure. As compared to 2D group, 3D group had less blood loss(35.0±16.8 ml vs. 44.3±18.2 ml, t=-2.449, P=0.016). No significant differences were seen in operative time(126.2±24.2 min vs. 131.8±30.2 min, t=-0.939, P=0.350), postoperative exhaust time(2.7±1.2 d vs. 2.8±0.9 d, t=-0.441, P=0.661), postoperative hospital stay (8.4±2.6 d vs. 8.6±2.5 d, t=- 0.363, P=0.717), number of lymph node dissection(16.4±3.4 vs. 15.8±5.2, t=0.623, P=0.535)between two groups. Conclusions It is safe to 3D rotatable laparoscopic anterior resection for rectal cancer. Compared with 2D laparoscopy, 3D rotatable laparoscopy is same in flexibility of operation, but it can give us more accurate space orientation, more distinct anatomical layer and more exquisite separation.