Objective To summarize the research progress of transanal endoscopic microsurgery in the treatment of rectal tumors. Method The literatures on transanal endoscopic treatment of rectal tumors was collected and reviewed. ResultsTransanal endoscopic microsurgery was one of the local resection methods. It was a minimally invasive surgery combining laparoscopy and endoscopy. Transanal endoscopic microsurgery equipment was mainly composed of special rectal mirror lens and high-pressure pneumoperitoneum machine. After full-thickness resection of the lesion, the defect was sutured under endoscopy, so as to avoid serious postoperative complications caused by radical surgery. Transanal endoscopic microsurgery was suitable for T1 stage rectal cancer with benign lesions such as rectal adenoma and rectal polyps and no lymph node metastasis. There was still some controversy about the treatment of higher-grade rectal cancer. Neoadjuvant radiotherapy and chemotherapy combined with transanal endoscopic microsurgery is being actively carried out in the treatment of rectal cancer. Conclusions Transanal endoscopic microsurgery is a safe and effective method for some rectal tumors. It has the characteristics of low perioperative complication rate, fast postoperative recovery and low recurrence rate.