Abstract: Preoperative radiotherapy increased local control rates of locally advanced rectal cancer. Short-course radiotherapy（25 Gy/5 f）or conventionally fractionated chemoradiotherapy（long-course radiation）are the most frequent therapies. Long-course radiation with concurrent chemotherapy presents higher tumor response rate. But the benefits of short-course schedule are the lower rate of toxicity and better compliance for patients. There are no differences in local control rate between the two schedules and superior to surgery alone. But overall survival rate has not been improved. Short-course radiotherapy with delayed surgery of a 4-8 weeks interval increased tumor complete response rate compared with short-course radiotherapy with immediate surgery of within 7-day. More recently，short-course radiotherapy combined with neoadjuvant chemotherapy and delayed surgery has been proposed as a promising regimen，which further improves pathologic complete response rate and even showes a trend toward being superior to longcourse chemoradiotherapy, and the local control rate is not inferior to the long-course schedule. Longterm outcomes involved decreasing distant metastasis rate and increasing overall survival rate need further study.