Small-cell carcinoma of the rectum, is very rare with a dismal prognosis that follows a more aggressive course than the pure exocrine counterparts. As a result, survival is usually very poor. A male patient with metastatic disease is presented in this report. After receiving six cycles of combination chemotherapy regimen consisting of cyclophosphamide, adriamycin, and etoposide, he is in complete remission for >3 years. Although it is a single case, it shows that combination chemotherapy may achieve an excellent result even in a metastatic case of small-cell carcinoma of the rectum.