Objective To explore the application of preventive ileostomy in sphincter-preserving after neoadjuvant therapy for low rectal cancer. Methods From June 2012 to July 2014, 103 patients with laparoscopic anterior resection for colorectal cancer after neoadjuvant therapy were divided into two groups. Experimental group was performed in 49 patients and were treated with preventive ileostomy after laparoscopic anterior resection. Stoma closure after 3 to 6 months. Control Group in the other 54 patients were treated with sphincter-preserving in laparoscopic anterior resection. Postoperative data were compared between two groups in the rate of anastomotic fistula and the average hospital stay. Results 103 patients were successfully treated. Experimental group had no one of anastomotic fistula, and the average hospital stay was 16.49±7.62d. Anastomotic fistula incidence occurred in the control group was 18.5%, and the average hospital stay was 23.52±12.61d. There was significant difference in these two aspects between the two groups (P﹤0.05). Conclusions Preventive ileostomy can reduce the risk of anastomotic fistula and hospital stay in laparoscopic anterior resection sphincter-preserving after neoadjuvant therapy for low rectal cancer. It can be used as a safe routine assisted surgery.