Objective <p>This study compares the clinical benefits of double-tube end ileostomy versus traditional end ileostomy in patients undergoing low anterior resection for rectal cancer.</p> Methods <p>A retrospective analysis was conducted on 65 patients who underwent laparoscopic radical rectal cancer surgery with preventive ileostomy between March 2022 and December 2024 at the First Affiliated Hospital of Anhui Medical University. Among these, 47 patients received traditional ileostomy, while 18 patients underwent double-tube ileostomy. The clinical characteristics and follow-up outcomes of the two groups were compared.</p> Results <p>Both groups showed no significant differences in intraoperative blood loss, postoperative bowel function recovery, or complication rates (<i>P</i> &gt; 0.05). However, the double-tube ileostomy group had superior outcomes: average stoma creation time was 25.39 ± 2.85&#xa0;min, postoperative hospital stays averaged 8.89 ± 2.30&#xa0;days, and total hospitalization costs were 57,796.50 ± 5306.30 RMB, all significantly lower than in the traditional ileostomy group (<i>P</i> &lt; 0.01). Complications were fewer in the double-tube group, with only one case of type A anastomotic leakage (5.56%) and no long-term complications following successful tube removal. By contrast, the traditional group had 4 cases of leakage (8.51%), and 16 patients experienced long-term complications, with only 40 (85.11%) achieving successful stoma closures. Furthermore, patients in the traditional group reported higher SCL-90 scores for somatization and sleep and eating problems (<i>P</i> &lt; 0.05), indicating significant differences between the groups.</p> Conclusion <p>Double-tube end ileostomy offers a safe and effective alternative to traditional methods, with shorter operative times, fewer secondary surgeries, and reduced physiological, psychological, and financial burdens on patients.</p>