To evaluate the clinical efficacy and safety of transanal minimally invasive surgery (TAMIS) for the treatment of benign rectal lesions so that patients can be provided with better surgical alternatives. A retrospective analysis was conducted on patients with rectal benign lesions who underwent TAMIS in the Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University from January 2018 to June 2019. The patients’ clinical data were thoroughly recorded, such as surgical-related information, postoperative pathology, and so on. At the same time, the patients were followed up regularly and carefully after the surgery. A total of 16 eligible patients were enrolled in the study. All patients underwent colonoscopy before surgery and the biopsy results showed that all the removed specimens were rectal benign tumors. All the lesions were resected with TAMIS. The average operation time was 111.94 ± 46.13 minutes. Among the 16 cases, 1 of the patients was found to have undergone peritoneal entry during operation 1 and this showed that the peritoneal cavity was penetrated during the operation. The average postoperative hospital stay was 4.56 ± 1.79 days. The final pathology of the TAMIS specimens revealed a malignant neoplasm in 10 patients, including 9 cases of rectal adenocarcinoma, 1 case of nerve endocrine tumor, and 6 cases of rectal adenoma. No long-term complications were observed during the mean follow-up time of 10.19 ± 5.14 months. TAMIS is a safe and effective minimally invasive surgical procedure for the treatment of rectal adenomas, which can minimize the adverse effect on anal function.