Anastomotic stenosis is a serious complication after anterior resection for rectal carcinoma. In this study, we explored the factors influencing the development of anastomotic stenosis after the operation. The clinical data of 420 patients who underwent surgery between January 2013 and December 2019 in the Department of Colorectal Surgery, Changshu Hospital Affiliated to Soochow University, were analyzed. The causes of anastomotic stenosis were investigated with logistic regression. A total of 52 patients developed anastomotic stenosis (12.4%). Univariate analysis showed that gender (chi(2) = 5.878, P = 0.012), protective stoma (chi(2) = 4.224, P = 0.038) and distance from lower edge of tumor to anal verge (t = 3.346, P = 0.001), and anastomotic leak (chi(2)= 9.432, P = 0.003) were statistically significant in the correlation of postoperative anastomotic stenosis. Logistic regression analysis showed that gender (OR = 1.662, 95%CI 1.026 similar to 2.694, P = 0.012), distance from lower edge of tumor to anal verge (OR = 0.856, 95%CI 0.822 similar to 0.892, P = 0.001), and anastomotic leak (OR = 2.455, 95%CI 1.192 similar to 3.863, P = 0.003) were independent factors of anastomotic stenosis. Male patients, the lower edge of the tumor close to the anal verge, and patients who had an anastomotic leak after surgery are more likely to develop anastomotic stenosis.