In this chapter, operative procedures for anterior, low anterior and abdominoperineal resections have been described in detailed. The criteria for each operative technique have been outlined. Merits between the sphincter-saving low anterior resection and the abdominoperineal resection of the rectum for carcinoma haven evaluated by various results. Merits for the different types of the perineal wound closure have also been highlighted. The management of the prolapsed rectum has been described.