We present our experience with intraoperative radiotherapy (IORT) multimodality treatment for patients with locally recurrent rectal cancer, but without distant metastases. Between 1994 and early 2000, 62 patients were treated according to a set protocol. Three-year survival rate was 49%. The local control rate was 63%. Total dose of irradiation and completeness of resection were significantly correlated to a better prognosis.