Objective To discuss and establish a simple, safe, less complication, convenient operative and apothesis way in protective ileostomy and to prevent anastomotic leakage happening in middle-low anterior resection for rectal carcinoma. Methods Clinical materials of 50 patients who received protective ileostomy after middle-low anterior resection for rectal carcinoma from Jan. 2013 to Dec. 2015 were retrospectively analyzed. Of which, 27 patients were sutured by longitudinal single-layer and the others were transverse multi-layer sutured. The indexes such as operation time, recovery time, complication with ileostomy, close stoma time and amount of bleeding were compared. Results All of the patients received protective ileostomy. There were no significant difference between the two groups in recovery time and complications with ileostomy (P >0.05). However, the operation time, close stoma time and amount of bleeding in the longitudinal single-layer suture group were significantly lower than that of the transverse multi-layer suture group (P < 0.05), also the former suture style was lower cost. Conclusions The way of longitudinal single-layer suture is a simple, safe, drastically divert the fecal stream, less complication, easy nursing and close stoma style of protective ileostomy.