Background: Traditional narrative operative reports have historically been of poor quality. Synoptic operative reporting has been utilized as an effective and efficient communication tool. For patients with rectal cancer, synoptic reports are required for pathology, radiology and major oncologic resections but have never previously been developed for transanal endoscopic surgery (TES). The objective of this study was to develop consensus-derived quality indicators (QIs) for TES reports. Methods: An online Delphi protocol was used. Colorectal surgeons and other key physician stakeholders across Canada were recruited to participate via a secure web-based platform. Delphi participants were asked to submit potential QIs according to 6 reporting themes proposed by the study authors, based on thorough literature review. The initial QIs were recirculated to participants and rated on 9-point Likert scales. Scores of 70% or greater were used for inclusion consensus, and scores of 30% or less denoted exclusion. Elements scoring 30% to 70% were recirculated by runoff in a subsequent round to generate the final list. Results: Fifteen physicians consented to participate, including 7 academic and 2 community colorectal surgeons, a surgical oncologist, a general surgeon with expertise in synoptic operative reporting, 2 gastrointestinal pathologists, an abdominal radiologist and a radiation oncologist. Round 1 achieved 100% (15/15) response and identified 79 potential QIs for consideration. Round 2 had an 87% (13/15) response, with 61 of the 79 proposed items reaching consensus for inclusion. Round 3 achieved a 93% (14/15) response. Sixty-seven items reached final inclusion. Conclusion: This study is the first to establish multidisciplinary, consensus-derived QIs for TES reports. This will allow generation of a synoptic reporting template to improve perioperative communication for these patients.