Multidisciplinary treatment approach in accordance with current guidelines represents a gold standard of care for patients with rectal cancer. Radical surgical resection is a fundamental and the only curative treatment modality. Patients with locally advanced rectal cancer (cT3-4N0M0 or anyTN1-2M0) are indicated for neoadjuvant radiotherapy or radiochemotherapy. However, there are many controversies regarding neoadjuvant radiotherapy indications in the available literature. Evidence-based medicine data suggest that neoadjuvant radiotherapy is associated with improved local control of the disease, but has no impact on patients survival. Moreover, neoadjuvant radiotherapy is associated with less favorable perioperative outcomes and significantly deteriorates anorectal function of patients after sphincter-preserving rectal resections.Key words: rectal cancer - radiotherapy - postoperative morbidity - survival - functional outcome.