Abstract: Objective To investigate the effect of preoperative chemoradiotherapy plus radical surgery on prognosis of patients with middle and low rectal cancer. Methods Clinical data about 286 patients with rectal cancer admitted to our hospital from February 2008 to February 2013 were collected. According to the occurrence of adverse prognosis during the follow-up period, the patients were divided into progression group and progression-free group. The survival curve was drawn and the prognostic factors of rectal cancer patients were analyzed. Results According to the prognosis of patients, 133 patients were included in progression group and 153 patients in progression-free group. The Kaplan-Meier survival curve showed that the average time to poor prognosis was 45.69 months(95% CI: 43.59 to 47.79), and the poor prognosis rate was 53.50%. Cox proportional hazard analysis showed that age (P=0.021), distance to anus (P=0.004), CEA> 3.40 ng/ml (P=0.035), and whether cCR (P=0.005) were independent prognostic factors. Conclusion Neoadjuvant chemoradiotherapy can improve the survival of patients with advanced rectal cancer to some extent. Distance to anus, CEA level, age, and whether cCR are correlated with the prognosis of patients with rectal cancer.