Objective: To investigate the safety and feasibility as well as short-term efficacy of robotic total endoscopic single anastomosis in treatment of rectal cancer. Methods: The clinical data of 124 rectal cancer patients treated from January 2016 to February 2017 in First Affiliated Hospital of Chongqing Medical University were analyzed retrospectively. Of the patients, 26 cases underwent da Vinci robotic surgery (robotic group) and the other 98 cases underwent traditional laparoscopic surgery (laparoscopic group). The main clinical data between the two groups of patients were compared. Results: The general data of the two groups of patients showed no significant difference (all P>0.05), and were comparable. In robotic group compared with laparoscopic group, the operative time was significantly prolonged (273.5 min vs. 234.3 min) and total hospitalization cost was significantly increased (82 000 yuan vs. 72 000 yuan), but the intraoperative blood loss was significantly reduced (43.3 mL vs. 68.4 mL), and the time to first postoperative gas passage (3.3 d vs. 4.4 d), liquid food intake (3.9 d vs. 5.4 d), ambulation (4.5 d vs. 6.8 d), and urinary tube removal (5.0 d vs. 6.8 d), as well as the length of postoperative hospital stay (10.0 d vs. 12.3 d) were all significantly shortened (all P<0.05). No open conversion was required in either group, and no significant difference was noted in terms of the distance of the distal resection margin, number of resected lymph nodes and the incidence of positive circumferential resection margin and postoperative complications between the two groups (all P>0.05). Conclusion: Robotic total endoscopic single anastomosis in treatment of rectal cancer is a safe and feasible operative technique, with advantages of less trauma, fast postoperative recovery, and short length of hospital stay, but its long-term efficacy still needs follow-up assessment.