This study aimed to assess the likely association of gut microbiome with low anterior resection syndrome (LARS) symptoms. Postoperative stool samples from patients with minor or major LARS after sphincter-preserving surgery (SPS) for rectal cancer were collected and analyzed using 16S ribosomal RNA sequencing method. The symptom patterns of LARS were classified into two groups (PC1LARS, PC2LARS) using principal component analysis. The dichotomized sum of questionnaire items (sub1LARS, sub2LARS) was used to group patients according to the main symptoms. According to microbial diversity, enterotype, and taxa,PC1LARSandsub1LARSwere associated with frequency-dominant LARS symptoms and patients, whilePC2LARSandsub2LARSwere grouped as incontinence-dominant LARS symptoms and patients.Butyricicoccuslevels decreased while overall LARS scores increased. The α-diversity richness index Chao1 showed a significantly negative correlation insub1LARSand a positive correlation insub2LARS. Insub1LARS, the severe group showed a lowerPrevotellaceaeenterotype and higherBacteroidaceaeenterotype than the mild group.SubdoligranulumandFlavonifractorshowed a negative and a positive correlation withPC1LARS, respectively, while showing a negative relationship withPC2LARS.LactobacillusandBifidobacteriumwere negatively correlated toPC1LARS. Frequency-dominant LARS had decreased diversity of gut microbiome and showed lower levels of lactic acid-producing bacteria.