Background: Anastomotic leakage (AL) is a significant and challenging complication following low anterior resection (LAR) for low rectal cancer. This report presents three cases treated with transanal intersphincteric incision surgery (TROPIS) combined with Kangfuxin liquid (KFL) enema. Case Presentations: We present three patients who underwent a laparoscopic LAR with diverting ileostomy for low rectal cancer. In case 1, a 39-year-old male patient presented two weeks post-discharge with fever and abdominal distension. Digital rectal examination revealed local detachment of the anastomosis. Case 2 was a 74-year-old male who on the fifth postoperative day experienced abdominal pain and high fever, with fecal fluid detected in the pelvic drainage tube. Abdominal CT confirmed AL. Case 3 was a 51-year-old male who, one week post-discharge, visited the outpatient clinic and digital rectal examination indicated AL located approximately 2.5 cm from the anal verge due to a local defect. Since the patient was asymptomatic, this was initially treated conservatively, however, despite one year of follow-up, complete healing was not achieved. All three cases of AL underwent TROPIS combined with Kangfuxin liquid (KFL) enema and completely recovered. Conclusions: The combination of the TROPIS technique and KFL enema appears to be an effective and safe therapeutic regimen for managing AL following LAR for rectal cancer with favorable outcomes, highlighting the potential of this combined approach in managing AL. Further research and clinical trials, however, are warranted to validate these findings.