To investigate the feasibility and safety of laparoscopy-assisted transvaginal resection of sigmoid cancer. From 2009 to 2011 we performed 21 laparoscopy-assisted transvaginal resections of sigmoid cancers. The resected tumours were T1(6), T2(7) and T3(8). The median number of resected lymph nodes was 15. Median operative time was 150 min and no conversion to open technique was necessary. A total of eighteen patients tolerated a liquid diet 24 h after surgery. The average VAS pain score (0 = no pain, 10 = unbearable pain) was 1.8 after 24 h and 1.1 after 48 h. One patient experienced a postoperative ileus, two patients had vaginal spotting with serous flow and three patients suffered urinary tract infections. One patient developed a hernia at the umbilical trocar site that was operated on. None of the sexually active patients reported any differences in sexual activity pre-op and postop on a postoperative questionnaire. After a median of 25 (10-41) months of follow-up, all patients are alive and well, with no evidence of recurrent disease. Laparoscopy-assisted transvaginal resection of sigmoid cancer is feasible and safe in a selected group of patients. Copyright © 2014 Elsevier Ltd. All rights reserved.