Objective:　To assess the effects of different procedures in the treatment of the primary lesion of rectal cancer associated with liver metastases. Methods:　Retrospective analysis of cases of rectal can-cer with liver metastases admitted from October 1991 to October 1999. Of these 43 patients, 30 were males, 13 were females, age range 33～75 year. The primary lesion of these patients underwent different surgical procedures, including anterior resection in 14 cases, abdominoperineal resection in 11 cases. Hartmann’s operation in 7 cases, and colostomy in 11 cases. Results:　Thirty-one cases of the series died, during the follow-up study, and the median survival time was 13.8, 13.7 and 9.2 months for those undergoing anterior resection, abdominoperineal resection and colostomy respectively. Of the 12 patients who were alive over one year, 2 survived for 8 years. There were no 1-yr survivors among the patients who underwent colostomy. Conclusions:　Aggressive surgical approach for the primary lesion is recommended in cases of rectal cancer associated with liver metastases in order to gain longer survivals.