Colorectal cancer is the third leading cause of cancer death worldwide. In China, the incidence and mortality of colorectal cancer are increasing, in which low rectal cancer is more common. Ultra-low rectal cancer refers to rectal cancer where the distance between the tumor and the anus is less than 5 cm, it accounts for about 70%-80% of rectal tumors. Intersphincteric resection (ISR), an important technical means for anal preservation of ultra-low rectal cancer, although could reduce the pain of patients during the surgical process, increase the anal preservation rate of patients and improve the life quality of patients, still has many adverse effects such as the high incidence of anorectal anastomotic leakage and high anterior resection syndrome. Many modified ISRs have emerged due to the limitations and adverse reactions of traditional ISR surgery. the purpose of this article is to review the progress of ISR surgery to improve its use in treatment.