A prospective comparison of laparoscopically assisted (n = 11) and conventional (n = 14) anterior resection in patients with sigmoid colon or upper rectal cancer was carried out. Patients were not randomized; age and the presence of metastases determined the type of surgery. Laparoscopic assistance was used to mobilize the tumour and minimize the abdominal incision. This was achieved in all patients and six of the 11 required only a muscle-splitting incision. The mean(s.d.) operating time was longer for laparoscopic than conventional surgery (205(31) versus 123(26) min, P = 0.01). The mean(s.d.) time to reintroduction of normal diet (2.5(0.2) versus 3.6(0.3) days, P = 0.01), postoperative analgesia requirement (2.6(0.4) versus 7.4(2.1) doses of pethidine, P = 0.01) and length of hospital stay (12.3(3) versus 14.3(6) days, P = 0.08) were less in the laparoscopic group. Histopathological examination of the resection specimens showed similar results for the two procedures. Major complications were few and occurred in a similar proportion of patients treated laparoscopically or conventionally. Laparoscopically assisted anterior resection is technically feasible, adequate tumour excision can be achieved and recovery after operation is enhanced.