Twenty patients with small rectal cancer, characterized by a well differentiated tumour localized within 10 cm of the anal margin, and by penetration limited to the submucosa or to the muscular layer, were treated by local excision. Four of them, who presented with a deep tumour invasion in the rectal wall, also received adjuvant radiation therapy. Our experience proves the reliability of the selection criteria for patients who may benefit from this procedure. They all stand a fair chance of cure and the quality of their lives will improve because local tumour excision avoids anal sphincter resection. Two patients had local recurrences and had to undergo further curative local excision. The two who died from their tumours and who had distant metastases were unsuitable for both local resection and other therapeutic procedure. Finally, there was no postoperative morbidity.