Objective To investigate the safety and feasibility of laparoscopic ELAPE for elderly patients with low advanced rectal cancer.Methods Totally 48 cases patients with low advanced rectal cancer surgery aged over 65 years old were analyzed retrospectively,who come from Beijing Hospital between Jan 2012 and Jan 2015.A total of 26 cases underwent Laparoscopic extralevator abdominoperineal excision (L-ELAPE) and 22 cases underwent Laparoscopic abdominoperineal excision(L-APE).Clinical data including general data,operation time,intraoperative blood loss,complications,pathological data,postoperative in hospitalization were retrospectively analyzed in patients.Results The mean operation time between L-ELAPE and APE group was (312±46)min vs.(245±62)min,mean intraoperative blood loss was(170±74)ml vs.(250± 109)ml,Operative complications was 26.9％ vs.27.3％,harvested lymph node was (16.0 ± 5.8)cm vs.(15.0±7.2)cm,intraoperative bowel perforation(IOP)rate was 0％ vs.18.2％,CRM involvement was 3.8 ％ vs.13.6 ％,mean postoperative hospital stay (days) was (13.1 ± 4.6) d vs.(13.7 ± 6.1) d.The mean operating time of L-ELAPE group was longer and mean intraoperative blood loss was much less than APE group,IOP rate and circumferential resection margin(CRM)involvement were higher in APE group(P＜0.05).Conclusions L-ELAPE is a safe and feasibility alternative approach for elder patients with rectal cancer.It is related with less intraoperative blood loss,IOP rate,CRM involvement and longer operating time contrast with L-APE.