Aims: To compare the effects of ovarian cancer cytoreductive surgery + Dixon surgery on ovarian cancer patients with rectal metastasis using either the Trendelenburg modified supine position or the Trendelenburg modified lithotomy position for surgery. Background: Trendelenburg modified lithotomy position, the most common surgical position for ovarian cancer cytoreductive surgery + Dixon surgery, might cause severe complications in patients who underwent surgery. As reported, Trendelenburg modified supine position is a safer surgical position to reduce the risks of surgical position complications and to increase the work efficiency. Design: This was a prospective study design. A total of 100 cases of late-stage ovarian cancer patients with metastasis in the sigmoid colon or rectum who underwent ovarian cancer cytoreductive surgery + Dixon surgery in Sun Yat-sen University Cancer Center between March 2013 and April 2015 were included in this study. The patients in the experimental group underwent surgery using the Trendelenburg modified supine position, and the patients in the control group underwent surgery using the Trendelenburg modified lithotomy position. Results: The time required for placement and recovery of the surgical position in the experimental group was shorter than that in the control group. The incidence of sacrococcygeal skin damage after surgery in the experimental group was lower than that in the control group. Conclusion: The placement and recovery of the Trendelenburg modified supine position was simple and quick, which was conducive to maintain the intraoperative stability of the hemodynamics and helpful for reducing the incidence of postoperative complications.