Abstract: Objective To evaluate the effects of the late course 3-dimensional conformal radiotherapy combined with chemotherapy for rectal cancer of postoperative local recurrence. Methods Forty-nine rectal cancer patients of postoperative local recurrence were divided randomly into two groups:25 cases received 3D-CRT plus chemotherapy(3D-CRT group),24 cases received conventional radiotherapy plus chemotherapy(conventional group).A total tumor doses of 46 Gy by the 6MVX beam to the all pelvic for conventional radiotherapy in the first course, followed in the 3D-CRT group by 3D-CRT to DT 70 Gy, in the conventional group by two field for conventional radiotherapy to 66 Gy. Two groups were all t reated one course by 5-Flu plus CF in the first week, and the last week. Kaplan-Meier method was used for survival analysis. Results 　The 1, 2, 3 years survival rates for 3D-CRT group and conventional group were 88. 0 %、64. 0 %、48. 0 % and 66. 7 %、45. 8 %、37. 5 % ( P = 0. 08) . The 3 years local cont rol rate for two group was 68. 0 %、41. 7 % ( P < 0. 05) respectively. The median survival was 35 and 22 months respectively. The side effect s were similar in the two group s. Conclusion 　3-dimensional conformal radiotherapy combined with chemotherapy can be considered as an effective and feasible approach to rectal cancer patient s of postoperative local recurrence, and may significantly improve the survival rate.