Aim. To determine the safety and feasibility of laparoscopic extralevator abdominal-perineal extirpation (ELAPE) of the rectum in comparison with the open surgery in low rectal cancer patients. Materials and methods. The study included 18 patients who underwent open ELAPE of the rectum, and 14 — laparoscopic ELAPE in the Department of Abdominal Oncology of the P.A. Herzen Moscow Research Oncology Institute in the period from February 2009 to February 2019. Intraoperative parameters, postoperative data, as well as data from pathomorphological examinations of removed specimens were studied in the compared groups. Discussion. Average time of the abdominal phase of the operation in open surgery was 146.1±55.5 minutes, and in laparoscopic variant — 140.7±28.9 minutes. Average intraoperative blood loss in open variation of the abdominal phase of the operation was 547.2±541.1 ml, and in cases with laparoscopic access — 314.3±257.5 ml. Average postoperative hospital stay in the group of laparoscopic ELAPE was 14.43±4.1 bed days (8—24), in the open-access group this parameter was 18.7±8.6 bed days (11—44). Conclusion. ELAPE with laparoscopic abdominal phase is an effective and safe surgical intervention in patients with low rectal cancer of the rectum in cases of optimal patient selection for this version of the operation.