Objective: To compare the clinical effects between preventive transverse colostomy and terminal ileostomy in low anterior rectal cancer resection. Methods: The clinical data of 79 patients with low rectal cancer undergoing low anus-preserving operation with preventive enterostomy were retrospectively analyzed. Of the patients, 33 cases received preventive transverse colostomy, and 46 cases received preventive terminal ileostomy. Between the two groups of patients, the incidence of postoperative anastomotic leakage and stoma-related complications as well as the serum levels of inflammatory factors were compared. Results: The preoperative data of the two groups of patients were comparable. Anastomotic leakage occurred in 2 cases (6.06%) in transverse colostomy group, and in 4 cases (8.70%) in terminal ileostomy group, and the difference between the two groups had no statistical significance (P>0.05). The incidence of wound infection in in transverse colostomy group was higher than that in terminal ileostomy group (P<0.05), but the incidences of all other stoma-related complications showed no significant difference between the two groups (all P>0.05). The serum levels C-RP and IL-6 levels in transverse colostomy group at 24, 48 and 72 h after operation were all higher than those in terminal ileostomy group (all P<0.05). Conclusion: Preventive transverse colostomy has similar effect as preventive terminal ileostomy in avoiding postoperative anastomotic leakage in low anterior rectal cancer resection, but terminal ileostomy is superior to transverse colostomy in terms of reducing postoperative trauma and stress responses, and complications.