Four cases of low anterior resection without pelvic drainage are described. The outcome was unsatisfactory in three of the four patients. The role of pelvic drains and omentum in the management of the pelvic space following low anterior resection for rectal cancer is reviewed and discussed. Pelvic drains are required to remove blood and omentum may be used to fill the pelvic space. Pelvic collections are related to anastomotic leakage and the optimal management of the pelvic space can reduce the incidence of this complication. A suggested regimen for management of the pelvic space after low anterior resection is outlined.