CT is an important diagnostic procedure in patients with suspected or known disease of the rectum. Knowledge of proper technique for CT of the rectum, as well as an understanding of normal pelvic anatomy, is essential to its effective use. CT can demonstrate the extent of perirectal and pararectal abnormalities detected on barium enema. While routine preoperative staging of rectal cancer is not justified, CT can be used to solve specific problems. Perhaps the most important role of rectal CT is in evaluating postoperative rectosigmoid cancer patients in an attempt to detect early asymptomatic recurrences and, thereby, prolong patient survival.