Abstract Introduction: Rectal atresia is rare, comprising only 1% of all anorectal malformations. Initial evaluation reveals a normal appearing anus located within the sphincter mechanism. A blind ending pouch is 3 cm from the anal verge. The anal canal and internal and external sphincters are well developed and there is no associated fistula. No technique has been frequently reproduced for this rare anomaly, and only one laparoscopic report exists. We present a laparoscopic and transanal approach for rectal atresia repair that provides minimal disturbance of the anal anatomy and achieves postoperative continence. Materials and Methods: A term, 3.5 kg male presented with failure to pass meconium and progressive abdominal distension. On physical examination, the external rectum appeared normal; however, rectal examination revealed a palpable, blind ending, web at 3 cm from the anal verge. The physical examination was otherwise normal. A contrast enema revealed a complete transverse web across the rectum. S...