Objective To investigate the clinical and pathological features of rectal carcinoid and factors influencing the prognosis. Methods Clinical data of 29 cases with postoperative pathology identified diagnosis of rectal carcinoid from May 1998 to May 2008 in the two hospitals were retrospectively reviewed. Endoscopic submucosal resection of the tumor was conducted in 5 cases,local resection in 14 cases, local expanded resection of the tumor in 4 cases, transsacral local wide resection in 2 cases, radical operation in 4 cases. Results Median age at treatment was 32～71 (54±11) years. Median follow-up was (61±4) months (3 months-10 years), follow-up rate was 76%. During a follow-up, there were no cases with recurrence among the 13 patients with tumor size<1 cm, 1 case recurred in the 5 patients with turmor size between 1 to 2 cm, and 3 cases died from postoperative liver metastasis among the 4 patients with tumor size > 2 cm. The 5-, 10-year disease-specific survival rates were 87% and 80% respectively. Conclusions Surgery is the best therapy for rectal carcinoid, the choice of operative mode must be made according to the size,infiltration of the tumor, the condition of infiltrated lymph node and hepatic metastasis.