The Purpose of the study: define the indications and contraindications to sphincterpreserving operation in lowerampullar cancer of rectum.The Materials and methods: In coloproctological branch of National Oncological Scientific centre (NOSC) in 2005-2009 years 142 patients were performed radical operations, 64 (45,1%) patients were performed sphincterpreserving operations – abdominoanal resection of rectum (AARR), medium age of patients - 59,8 years, beside 78 (54,9%) patients were performed abdomeno - perineal extirpation of rectum (APER), medium age - 54,2 years.The Results: Studied results of the morphological research of removed preparation by histological structure of tumors and by form of the growing, depending on locations of the tumors on toothed line. The remote postoperative results studied beside 51 (79,7%) patient with AARR and beside 63 (80,1%) patients with APER.The Findings: sphincterpreserving operations (SPO) of the rectum can be the operation of the choice in treatment of high differentiated adenocarcinoma (HDA) and medium differentiated adenocarcinoma (MDA) in stages T2-3 in localization of the lower pole of tumors, not below1 centimeter of toothed line (TL) and carries combined character, in location of the lower edge of tumors on toothed line in patients with HDA MDA in 4% and 2,2% cases are shown that completing intrasphincternal resections of rectum, in connection with particular aggressiveness LDA question about choice of the method of the treatment under their localizations directly on TL must be solved in favour of complete APER, in exophytic tumor located onto and above TL is indication for sphincterpreserving operation in type of AARR, indices recurrence-free and not metastatic period, one-year death-rate, three-year survivability after SPO at inferior ampular cancer of rectum has not an essential distinction from results after APER.