Abstract: Objective:To explore the risk factors for rectovaginal fistula following total mesorectal excision in elderly female patients with rectal cancer,and to provide theoretical basis for the prevention.Methods:Thirty-six elderly female patients suffering from rectovaginal fistula after total mesorectal excision for rectal cancer were evaluated by single factor inspection and logistic regression analysis.Results:The factors related to the occurrence of rectovaginal fistula were as follows:the tumor was located in the rectum anterolateral(Or=2.413),the double stapling was used in the operation(Or=2.171)and the distance from tumor to anal was less than 10 cm(Or=1.833);the other factors involved were tumor stage(Or=1.547),preoperative radiotherapy(Or=1.233)and menopausal(Or=1.043).Conclusions:The tumor in the anterolateral position,use of the double stapling,distance of tumor to anal less than 10 cm,tumor stage,preoperative radiotherapy and meopausal are all the risk factors for rectovaginal fistula.Clinicians should take active measures to prevent the occurrence.