This video article demonstrates a robotic abdominoperineal resection (APR) with bilateral gracilis flap reconstruction for a 52-year-old patient with metastatic rectal cancer. The procedure is performed as a potential palliative or curative measure following favorable response to chemotherapy. Key components include robotic total mesorectal excision, careful pelvic dissection preserving critical structures, and construction of an end colostomy. Concurrently, bilateral gracilis muscle flaps are harvested and tunneled into the pelvis to reconstruct the irradiated perineal floor. This multidisciplinary approach combines oncologic resection with immediate reconstruction, aiming to optimize outcomes and reduce recovery time through a minimally invasive, efficient technique.