SITUS INVERSUS TOTALIS is   a rare congenital condition   characterized by complete transposition of the thoracic and abdominal viscera .  Several reports on surgical procedures in SIT patients have documented greater technical difficulties, as the anatomy is abnormal.   Laparoscopy can prove to be an even greater technical challenge . Although laparoscopic colorectal surgery has recently become a standard procedure, there are very   few  available  literature   on laparoscopic surgery for rectal neoplasms  in patients with SIT.       We present an overview of the operative technique of laparoscopic low anterior resection for  rectal cancer. Careful consideration of the mirror–image anatomy permitted a safe operation.  Therefore, curative laparoscopic surgery for rectal cancer in patient with SIT  is feasible and safe. We report a case of a 65 year old female who  presented with an Ulcero–proliferative growth about 6cms from the anal verge, with  Situs Inversus Totalis.  Laprosocpic low anterior resection was performed successfully  by careful consideration of the mirror–image anatomy. The operative time was 240  minutes  and no intraoperative complications occurred. The postoperative course was uneventful, and the patient was discharged on postoperative day 16.