Patients with rectal cancer mainly present with increased stool frequency, incomplete stool feeling and/or blood and mucus on the surface of the stool, for which rectal examination is required. For the high-risk group with the following medical history over 40 years of age, routine full colonoscopy should be performed to detect combined benign or malignant colorectal lesions (1-3% of rectal cancer combined with colon cancer, 20-30% of rectal cancer combined with colorectal polyps): 1. family history of rectal cancer; 2. family history of adenomatous polyps; 3. history of colorectal adenomas or polyps; 4. history of ulcerative colitis. All patients with rectal cancer should undergo preoperative imaging to determine whether there are distant metastases, and the organs most likely to be metastasized by rectal cancer are liver and lung. CT examination can not only evaluate the local invasion of the primary tumor, but also detect the coexistence of distant metastases. Further preoperative staging of the tumor can be performed by choosing rectal ultrasound endoscopy or MRI. There is now increasing evidence that preoperative neoadjuvant therapy can lead to greater efficacy, less adverse effects and better prognosis. There is no significant difference between laparoscopic and open surgery for rectal cancer in terms of recurrence and overall survival, but laparoscopic surgery is less invasive, has fewer complications, and has faster recovery, which has greater advantages compared with open surgery, but laparoscopic rectal cancer surgery requires the cooperation of a professionally trained team to be safe. Reviews, meta-analyses, and clinical studies have reported that laparoscopic surgery is safe and feasible and has a similar or better prognosis than open surgery, but higher-level evidence is still needed to support this. In the case of rectal cancer with concurrent liver metastases, resection of the primary lesion and liver metastases can be performed concurrently or by staged surgery. In patients with unresectable metastases or those who cannot tolerate surgical resection for medical reasons, treatment depends mainly on the presence of symptoms; those with symptoms can be treated with chemotherapy alone or resection of the affected rectum or stoma surgery or rectal stent placement to relieve obstruction; the main treatment should be systemic chemotherapy effective for metastatic disease.