The role of radiotherapy in the management of rectal and rectosigmoid cancer is still far from clear. Our experience with 98 patients is presented: eight patients were treated with radical radiotherapy, 13 received postoperative radiation, and 67 were treated for palliative purposes only (bleeding, pain, mass, and fistulation). Satisfactory results were demonstrated in all three categories, and sterilization of disease by radiation was histologically proven in three cases. The necessity of high-dose radiation for the achievement of optimum results is demonstrated, and the techniques and problems are described.