Rectal cancer with liver metastasis, also known as metastatic bowel cancer, usually cannot be surgically resected and is called advanced bowel cancer. The main treatment means is internal medicine to treat rectal cancer liver metastases, and at present, surgical resection is the best method to treat rectal cancer liver metastases. Perioperative chemotherapy can reduce the tumor load, improve the probability of complete resection and reduce the chance of recurrence after surgery. A portion of patients with initially unresectable liver metastases can be converted to resectable lesions after chemotherapy and can undergo surgery in due course. The perioperative chemotherapy regimen for liver metastases mainly includes FOLFOX, FOLFIRI, etc. However, in order to reduce the adverse effects of chemotherapy on liver surgery, the courses of chemotherapy should not be too many. In principle, the total courses of preoperative and postoperative treatment should not exceed six cycles.