AIM: to evaluate results of transanal total mesorectal excision (TA TME) for rectal cancer. PATIENTS AND METHODS: Ninuty patients were included the prospective non-randomized study. Forty-five (50.0 %) of them underwent TA TME and 45 (50.0%) - conventional total mesorectal excision (TME). RESULTS: operation time was significantly higher in TA TME group: 276.4± 56.9 (190-400) minutes vs 188.0± 56.7 (100-310) minutes in open TME group (р=0.0001). The intraoperative complications rate was significantly higher in TA TME group: 7 (15.5 %) vs 1 (2.2 %) patient (р=0.05). No significant difference in postoperative morbidity was obtained: 18 (40.0%) in TA TME group vs 17 (37.7%) (р=1.0). Postoperative stay was lower in TATME group: 9 (7:14) vs 11 (10:14) days (р=0.04). Grade 2 specimen quality was detected significantly more often after TATME 26 (57.8 %) vs 15 (33.3 %) open TME (р=0.03), while Grade 3 specimens were more common after open procedure - 30 (66.7 %) vs 13 (28.9 %) TA TME group (р=0.0006). CONCLUSION: TA TME is a feasible procedure for rectal cancer patients. It demonstrated all benefits of minimally invasive technique, though learning curve is steep.