A 60-year-old woman with locally advanced rectal cancer, which had infiltrated into the vagina, was referred to our department in September 2010. She received 4 courses of neoadjuvant chemotherapy; the tumor size reduced, but the fistula was not closed. Because the tumor size had reduced, we performed a laparoscopic surgery. The laparoscopic surgery involved perineal proctectomy and resection of the posterior wall of the vagina, along with dissection of the bilateral lymph nodes. The efficacy of the neoadjuvant chemotherapy was judged as Grade 2. Neoadjuvant chemotherapy should be considered in patients with locally advanced lower rectal cancer with infiltration into other organs.