Due to improved interdisciplinary staging, rectal cancer can be treated in a more individualized manner. Over the last decade, high-quality resection has reduced the incidence of local recurrence. In locally advanced situations, patients receive multimodal treatment, based on preoperative RTx/RCTx, which is completed with chemotherapy after the operation. Further studies concerning dose effects, changing chemotherapeutic agents, adding antibodies, and extending the total mesorectal excision (TME) technique to rectal cancer in the upper third to improve the efficiency of the multimodal therapy are in progress.