This is a clinical practice guideline for patients with early rectal cancer. The guideline provides recommendations on diagnosis, staging, and treatment. Local excision, rectal resection, and total mesorectal excision are discussed as surgical options, and laparoscopic and open approaches to abdominal surgery are compared. The use of neoadjuvant (chemo) radiation therapy is also discussed. Outcomes of interest include diagnostic accuracy, sensitivity, and specificity of diagnostic and staging procedures, local recurrence, survival (5-year, overall, disease free), distant metastases rate, morbidity, and quality of life.