A 76-year-old woman consulted her local physician because she experienced anal pain during defecation. She was diagnosed with squamous cell anal carcinoma and underwent chemoradiation (59.4 Gy + UFT 500 mg/5 days/week). The examinations after chemoradiation revealed a complete remission of the tumor. She was followed up and 8 months later, she experienced anal erosion and pain. Local recurrence was observed, however, distant metastasis was not observed. Abdominoperineal resection (APR) was performed as salvage treatment, and she has been disease free for 10 months. Functional preservation employing concomitant chemoradiation has become the standard treatment for most case of squamous cell anal carcinoma, with APR backup being a salvage procedure. However, approximately 30% of the cases require a salvage operation because of primary non-response or recurrence. We predict that the incidence of such cases will increase in the future.