Radiotherapy, surgery and chemotherapy are the main treatments for cancer. Though intraoperative radiotherapy(IORT) for rectal cancer is still at its preliminary stage in China, patients can get more benefits from IORT than pre- or post-operative radiotherapy. IORT improves local control for locally advanced rectal cancer and improves overall survival rate of locally recurrent rectal cancer. In general, IORT is safe and feasible. It will be widely used for patients with rectal cancer in the future.