The most important quality parameters of rectal cancer surgery are oncological radicality, postoperative complications, recurrence rate and survival. Rectal dysfunction following low anterior resection occurs in up to 25-50% of patients. Despite its high frequency, however, it does not receive enough attention. Rectal dysfunction after surgery includes frequent bowel movements, urgency, incomplete evacuation, incontinence or sexual and urinary dysfunctions. The complex of symptoms is collectively referred to as the low anterior resection syndrome - LARS. In this review, we discuss the alterations in anorectal physiology after low anterior resection, the etiology and risk factors of LARS, different types of neorectal reservoir construction, and various options for prevention and treatment of LARS. Furthermore, sexual and urinary dysfunction is briefly reviewed.low anterior resection bowel dysfunction incontinence anorectal physiology.