Whether 76-year-old patients with rectal cancer need surgical treatment needs comprehensive evaluation. If patients meet the indications for surgery and have no relevant contraindications for surgery, radical surgery can be considered, and palliative surgery can be considered in case of some emergencies. For elderly rectal cancer patients who are in good physical condition, have no relevant contraindications to surgery and no distant metastasis, radical resection can be considered, which can be supplemented by regional lymph node dissection according to the situation, which can greatly reduce the recurrence rate and prolong the survival time of patients. For patients who have developed liver metastasis, but the metastatic foci can be resected after evaluation, combined resection of primary foci and metastatic foci can also be performed. If the patient is not suitable for radical surgery, but there are some emergencies, palliative surgery can be considered to relieve the patient’s pain and save the patient’s life. For example, stoma can be performed when rectal cancer causes serious intestinal obstruction, and palliative resection can be performed when tumor bleeding is obvious or complicated by intestinal perforation. It is not suitable for surgery if the patient has the following conditions: the patient’s basic condition is poor, unable to tolerate surgery and prolonged anesthesia; the patient has serious malnutrition or liver or kidney insufficiency; the patient has serious coagulation disorder; the patient is in the acute stage of basic diseases, such as the acute stage of myocardial infarction, and so on. Surgery is also not recommended when extensive metastases have developed and surgery is not beneficial. If a 76-year-old man suffers from rectal cancer, it is recommended to go to the hospital as soon as possible and ask a professional doctor to fully evaluate his condition before deciding whether or not to perform surgery.