Objective: To compare the short-term outcomes of robotic and laparoscopic radical resection for middle and low rectal cancer. Methods: A total of 100 consecutive patients with middle and low rectal cancer (the inferior margin of the lesion locating no more than 12 cm from the anal verge) admitted in the First Affiliated Hospital of Nanchang University from October 2016 to May 2017 were enrolled. Based on the principle of sequential design, the patients were randomly assigned to robotic group and laparoscopic group with 50 cases in each group, and underwent robotic and laparoscopic middle and low rectal cancer radical surgery respectively. The main clinical variables between the two groups of patients were compared. Results: There were no differences in preoperative data between the two groups (all P>0.05). Operations were successfully performed in all patients, without any open conversion. Negative circumferential resection margins were achieved in both groups and the integrity of mesorectum was impaired in one case in laparoscopic group. In robotic group compared with laparoscopic group, the average intraoperative blood loss (67.1 mL vs. 134.6 mL), operative time (123.2 min vs. 152.6 min), time for postoperative gastrointestinal function recovery (45.7 h vs. 51.8 h), time to first postoperative food intake (52.9 h vs. 64.3 h) and time to urinary catheter removal (4.4 d vs. 4.9 d) were significantly reduced, but the average hospitalization cost (56 000 yuanvs. 42 000 yuan) and costs associated with surgery (31 000 yuanvs. 17 000 yuan) were significantly increased (all P<0.05). There were no significant differences in surgical procedures, length of the resected specimen, number of the resected lymph nodes, postoperative pathological results, length of postoperative hospital stay and non-surgery costs between the two groups (all P>0.05). Conclusion: Robotic surgery for middle and lower rectal cancer is safe and feasible, and has advantages of less trauma and fast postoperative recovery in comparison to laparoscopic surgery.