&NA;A review of 282 patients with carcinoma of the rectum treated by local excision suggests that some patients are best managed and perhaps preferably managed by local means.In situcancer is treated adequately by local excision regardless of size or grade. Well‐differentiated lesions, particularly those less than 3 cm in diameter, probably are managed best by local excision. Moderately or poorly differentiated lesions, regardless of size, probably are managed best by radical techniques until more information is available to document results with local excision.