Treatment of malignant disease by laparoscopic methods is still controversial. Laparoscopic magnification provides superb visualization of deep pelvic structures and planes of dissection. This case illustrates a step-by-step approach to a laparoscopic oncologic procedure: 1) Inspection of the abdominal cavity and liver; 2) Preliminary ligation of the inferior mesenteric artery and vein; 3) Mobilization of the proximal colon with division of the mesentery and proximal colon; 4) Rectal mobilization with pelvic nerve preservation and total mesorectal excision; 5) En bloc resection of the tumor with surrounding soft tissues; 6) Stoma formation. This case involves a 54 year old female with a squamous cell carcinoma of the anus. The patient underwent preoperative chemoradiation following the Nigro protocol with paradoxical increase in growth of the tumor. 4 weeks later she underwent an elective laparoscopic abdominoperineal resection. The perineal phase was performed using conventional surgical techniques. Intraoperative course was uncomplicated with total operative time of 240 min. and a blood loss of 100 ml. Pathology revealed distal, proximal and lateral margins clear of tumor. The patient did well post operatively and was discharged on post operative day 4 without complications. Using a defined step-by-step approach, a laparoscopic oncologic abdominoperineal resection was successfully accomplished and documented in a patient with locally advanced anal squamous cancer. Laparoscopic techniques may be employed to accomplish an abdominoperineal resection for an advanced anal cancer.