According to AJCC colorectal cancer staging, rectal cancer T4N0M0 belongs to stage II. Rectal cancer is a relatively common malignant tumor of digestive system in clinic, and pathological staging can guide the choice of treatment plan for patients. For T4 stage, it indicates that the tumor has penetrated the dirty peritoneum or directly invaded or adhered to the neighboring organs and structures, and N0 and M0 indicate the absence of lymph node and distant metastasis. These patients need to evaluate the location of the lesion, the patient’s general physical condition, pathological staging and the degree of differentiation to assess whether further adjuvant radiotherapy and chemotherapy are needed, which can help to reduce the probability of recurrence and metastasis in patients. Therefore, rectal cancer T4N0M0 belongs to stage II relatively early staging, but further treatment options should be considered according to specific circumstances to help improve the efficacy.