In spite of the fact that rectal stromal tumor accounts for only 4.2% of the gastrointestinal stromal tumor, its surgical treatment is still very difficult and challenging due to the special anatomical position of rectum, its complicated anatomical relationship with adjacent organs, and whether the anus be preserved. Local resection of rectal stromal tumor is feasible and reasonable owing to its biological characteristics. However, there are many approaches and methods for local resection and no consensus has been reached. The clinical data of 18 patients with rectal stromal tumor who were treated by local resection via transposterior approach at the Peking Union Hospital from March 2003 to September 2012 were retrospectively analyzed. The surgery not only applies with the oncology treatment principle, but alsopreserves anus and limits the surgical injury to a large extent. Therefore, it is one of the most ideal surgical methods for the treatment of rectal stromal tumor.