One of the most common malignant tumors in the elderly is rectal cancer, and the main manifestations of rectal cancer in the elderly are still blood in the stool, abdominal pain or acute bowel obstruction. For rectal cancer in the elderly, the treatment is still decided according to the stage. If it is early rectal cancer, that is, there is no lymph node metastasis around the intestine. If the depth of invasion of the mass is mucosa, submucosa or muscle layer, the treatment is still mainly radical surgical resection. If there is peri-intestinal lymph node metastasis or distant metastasis, synchronized chemotherapy or chemotherapy should be used, and surgery is not the first choice. If the physical condition is poor and cannot tolerate surgery, the main treatment is palliative treatment, and in case of acute intestinal obstruction, rerouting surgery should be adopted, and then synchronous radiotherapy and chemotherapy for rectal cancer should be performed.