Pelvic lymph node metastasis of rectal cancer can be treated by surgical resection if the lesion is small and limited, and radiotherapy and targeted therapy are also needed to be carried out as auxiliary treatments at the same time. After pelvic lymph node metastasis of rectal cancer, if the metastatic lesion is small and limited, radiotherapy and targeted therapy can be used to shrink the tumor lesion and inhibit tumor proliferation and metastasis before surgery, and then the metastatic lesion can be removed through surgical treatment. If the pelvic lymph nodes of rectal cancer have multiple metastases and large foci, it is difficult to be resected by surgery, then radiotherapy and targeted therapy can be used to improve the prognosis of the disease, prolong the survival time of the patients, and improve the quality of life of the patients. Therefore, when pelvic lymph node metastasis of rectal cancer occurs, it is recommended to receive further examination and choose whether to have surgical treatment or not under the doctor’s comprehensive evaluation, and follow the doctor’s instructions to prolong the life cycle.