Objective To study the clinical value of neoadjuvant radiotherapy (NRT),neoadjuvant chemoradiotherapy (NCRT) or surgery alone (S) in treatment of middle and low rectal cancer.Methods 139 cases were divided into 3 groups:47 cases were given NRT (50 Gy/25 f/5 w) as group NRT,46 cases were given NCRT (Capox+ radiotherapy) as group NCRT,and the remaining 46 cases were treated with surgery alone as group S.Patients in 3 groups were followed-up for 3 years for the observation of the rates of anuspreserving and 3-year survival rates.Results Compared with the patients in group S,the rates of anuspreserving in group NRT and NCRT were significant improvement [74.47 ％ (35/47) and 73.91％ (34/46) vs 54.35 ％ (25/46)],(x2 =4.111,3.827; P=0.043,0.050).The 1,2,3-year survival rates of the 3 groups had no significantly different (P ＞0.05).However,the 1-year survival rates might be lower in group NRT and group NCRT than that in group S [87.23 ％ (41/47) and 88.89 ％ (40/45) vs 97.83 ％ (45/46)] (x2 =4.611,P =0.100).Conclusion NRT and NCRT can improve the rate of anus-preserving,but might not improve the 1,2,3-year survival rate,instead,the death rate may increase in the first year.