Purpose: To evaluate the surgical outcomes of abdominal radical trachelectomy(ART) and the efficacy of transrectal ultrasonography in determining the upper end of cervical incision during this operation. Materials and Methods: ART was performed in five patients with early-stage cervical cancer in the present clinic. In the first three patients, uterine corpus was transacted blindly at a level of approximately five mm below the internal os. In the last two patients, the authors performed transrectal ultrasonography before vaginal incision to evaluate the distance between upper margin of tumoral mass and internal os of cervical canal. Results: Mean follow-up was 21 months. During this period, menstrual abnormality occurred in three patients. The two patients in which transrectal ultrasonographies were taken intraoperatively had 9- and 12-mm postoperative cervical canal length and both of them were asymptomatic postoperatively. Conclusions: ART is usually associated with menstrual abnormality at late postoperative period and transrectal ultrasonograph during this procedure may decrease postoperative morbidity.