Management of rectal cancer is changing, due to better screening programs. An increased number of early rectal cancers are found, for which a radical surgery is not necessary in every cases. The development of new transanal resection techniques by minimally invasive surgery or robotics, allows to offer the patient less invasive technique with a better quality of life and sometimes preventing the creation of a stoma. This article summarizes the current situation in the field of transanal resection for early rectal cancer and the results in terms of oncologic and surgical outcomes. An appropriate selection of the patients is necessary to define who can benefit the most from these techniques.