Intersphincteric resection (ISR) for low rectal cancer has been described as the ultimate sphincter-saving procedure. Laparoscopic ISR has been proved safe with early postoperative benefits. Recently, some colorectal surgeons have begun to perform robot-assisted ISR to harness the advantages of the da Vinci robotic system. The authors present their short-term results for a robotic technique of ISR. Data from 29 consecutive patients at a single institution with very low rectal cancer (<4cm) from the anal verge who underwent robot-assisted ISR were prospectively collected between December 2007 and March 2010. The study enrolled 23 men and 6 women with a median age of 61.5years (range, 36-82years). Their median body mass index (BMI) was 23.3kg/m(2) (range, 17.9-32.5kg/m(2)). The median distance of the tumor from the anal verge was 3cm (range, 1-4cm). The median operative time was 325min (range, 235-435min), with a console time of 130min (range, 110-210min). There were no conversions to open surgery. A protecting ileostomy was performed for all the patients. The median blood loss was less than 50ml (range,<50-1,000ml). The median size of the tumor was 3cm (range, 0-6.9cm), and the median number of lymph nodes harvested was 16 (range, 1-44). The median distal margin was 0.8cm (range, 0-4cm), and one margin was positive. The circumferential margin was negative (>2mm) for 27 patients. Therefore, complete resection (R0) was achieved for 26 (90%) of the 29 patients. The median hospital stay was 9days (range, 5-15days). Nine patients experienced complications, including three anastomotic leaks (10%). All the leaks were managed conservatively. No surgical mortalities occurred. Robot-assisted intersphincteric resection for very low rectal cancer is feasible, and its short-term outcome is acceptable.