Abstract: Lateral lymphatic drainage is one of the three important directions for low rectal cancer. Radical surgery of rectal cancer requires the dissection of lymph nodes along the drainage route which determines the extent of lymph node dissection. However, controversial arguments exist whether lateral lymph node belonging to the regional lymph node or the distant lymph node. This arguments has also brought the controversy about neoadjuvant chemoradiotherapy and lateral lymph node dissection, as well as the controversy about efficacy of neoadjuvant chemoradiotherapy on lateral metastatic lymph nodes. Combined with the preliminary clinical practices, the authors comprehensively analyze research advances at home and abroad, further elaborate the lateral lymph node metastasis of rectal cancer, the risk factors affecting lateral lymph node metastasis and tumor recurrence, and the evaluation of lateral lymph node by magnetic resonance imaging before and after chemoradiotherapy, et al, in order to investigate the selection and significance of lateral lymph node dissection in advanced low rectal cancer after neoadjuvant chemoradiotherapy.