Purpose: to assess and compare functional outcomes and quality of life of patients after low anterior resection with and without formation of a colonic reservoir. Object and methods of the study. The trial included 40 patients who underwent low anterior resection with formation of a lumbar 2-fold reservoir — group I, according to the clinic’s method, and 40 patients with end-to-end colorectal anastomosis formation — group II. The functional outcomes of surgical treatment and quality of life of patients were analyzed (assessment by LARS, Wexner, FIQL). Results. Manifestations of low anterior resection syndrome 12 months after surgery were more often observed in group II (2.8 to 2.0, respectively). During the 1st year, a gradual improvement in the function of the sphincter apparatus of the rectum was observed in both groups, but more satisfactory results were observed in group I. The quality of life according to the FIQL in group I was significantly better than in group II in the «lifestyle» scale (3.1 and 2.6, respectively) 12 months after surgery. Conclusion. Based on the data obtained and the study of the quality of life of patients, the advantages of forming a lumbar 2-fold reservoir after performing low anterior resection of the rectum in patients with distal rectal cancer are substantiated. Functional results and quality of life of patients after low anterior resection with the formation of a 2-fold reservoir are higher than without a reservoir.