In recent years, with the improvement of people’s living standard and change of dietary habits, the incidence and mortality rate of rectal cancer in China has shown an increasing trend. Compared with colon cancer, rectal cancer is more prone to pelvic recurrence. An optimal individualized treatment plan tailored for rectal cancer patients should consider both the degree of radical cure achieved by surgery and the functional outcome brought by the treatment. Clinical staging is the guiding factor for decision making in the first treatment selection of rectal cancer patients, and incorrect clinical staging often brings significant impact on the treatment outcome. Negative T1 to T2 lymph nodes: transabdominal resection is possible. Well-differentiated T1 does not require any treatment after surgery. Pathology after T1 transanal resection suggests hypodifferentiation, positive cut margins or vascular or lymphovascular infiltration, requiring transabdominal resection in. T2 with negative margins after transanal resection and no poor prognostic histological features may be treated with transabdominal resection or chemoradiotherapy. T3, N0 or any T, N1 to 2 should be treated with preoperative chemoradiotherapy. unless the patient has a contraindication to chemoradiotherapy. Chemoradiotherapy should be given for T4 or unresectable patients. Those who can be resected after radiotherapy are given resection and then 6 months of chemotherapy after surgery.