Clinical data of 23 elderly patients with rectal cancer undergoing trans-sphincteric local resection(TSLR, Mason's operation)were retrospectively analyzed. All the 23 patients were followed-up for three to seven years after operation, 18 with normal or good fecal continence(78%), five just in fair condition(22%)and none in fecal incontinence. Three-year survival was 83 percent(19/23)and 5-year survival was 78 percent(18/23)for them. It is suggested that TSLR is a safe, feasible and effective treatment for middle and low rectal cancer in the elderly with a long term survival and satisfactory quality of life.