&NA;From 1972 to 1976, 11 patients received moderate‐dose pelvic preoperative radiation therapy (4500‐4600 rad ±500 rad boost) for initially unresectable rectal or sigmoid carcinoma. Of six patients subsequently explored, five had radical surgery and are alive without disease at least five years later. Comparison of the present long‐term follow‐up series with prior (short‐term follow‐up) series suggests that moderate‐dose preoperative pelvic radiation therapy can convert many of these lesions to being resectable ones for which long‐term survival‐without‐disease can be achieved. Attention to irradiation dose and field size is stressed, and a suggestion is made that patients whose tumors at final pathology still demonstrate extrarectal extension receive postoperative small‐field boost irradiation.