OBJECTIVE: To evaluate clinical outcomes and quality of life in terms of anal, urinary, and sexual function, after low anterior resection for rectal cancer. DESIGN: Retrospective study. SETTING: University hospital, Switzerland. SUBJECTS: 43 patients with low rectal cancers. INTERVENTIONS: 27 were not given adjuvant radiotherapy and 16 had preoperative adjuvant radiotherapy 1.6 Gy twice daily for 13 days. MAIN OUTCOME MEASURES: Anal, urinary, and sexual function postoperatively. RESULTS: 23 patients reported normal defaecation (53%), 9 had incontinence of flatus (21%), 5 had occasional minor soiling (12%), 2 had frequent major soiling (5%), 4 had a total faecal incontinence (9%), and 3 had urinary incontinence (7%). Sexual dysfunction was reported by 9 of the 13 sexually active men and 2 of the 11 sexually active women. CONCLUSION: Despite their reported faecal, urinary and sexual dysfunction most patients were satisfied with their quality of life. Counselling at the time of operation is highly recommended as a means of contributing to personal satisfaction.