〔Abstract〕 Objective To investigate the short-term clinical outcomes and long-term prognostic value of preserving the superior rectal artery (SRA) versus high ligation of the inferior mesenteric artery (IMA) in laparoscopic sigmoid colon cancer resection (LSCER) for sigmoid colon cancer (SCC). Methods A retrospective comparative analysis was performed of 316 SCC patients who underwent LSCER. Patients were divided into the SRA preservation group (Group A,132 cases) and IMA high ligation group (Group B,184 cases) according to the vascular management strategy. Short-term clinical indicators and long-term follow-up outcomes were compared between the two groups. Results There were no significant differences in baseline data between the two groups (P > 0.05). The mean operation time of Group A was (190 ± 61.9) minutes, which was significantly longer than that of Group B [(165 ± 49.1) minutes, P < 0.001]. However, Group A demonstrated significantly shorter time to drain removal, time to first flatus, and postoperative hospital stay (P < 0.001). No significant differences were observed in intraoperative blood loss, number of lymph nodes dissected, or incidence of anastomotic leakage (AL) between the two groups. Long-term follow-up results showed that there were no significant differences in 3-year overall survival rate and 3-year disease-free survival rate between the two groups. Conclusion Laparoscopic sigmoid colon cancer resection with SRA preservation is safe and feasible for the treatment of SCC. Although the operation time is slightly prolonged, it can effectively promote short-term postoperative recovery without affecting the curative effect of tumor resection or long-term prognosis, and thus has important clinical promotion value.