Rectal cancer is one of the most prevalent cancers world-wide. It is also a paradigm for multimodal management, as the combination of surgery, chemotherapy and radiotherapy is often necessary to achieve the optimal outcome. Recently, international experts met in Heidelberg, Germany to discuss the latest developments in the management of rectal cancer, including the anatomic and pathologic basis, staging tools, surgical concepts including fast-track surgery and laparoscopic resection, functional outcome after surgery and the role of radio- and chemotherapy. This monograph summarizes this meeting and gives an extensive overview of the current concepts in management of rectal cancer.