Abstract: The diagnosis and treatment of rectal cancer have entered the era of precision. Accurate diagnosis helps clinicians to accurately assess the risk of recurrence and metastasis of rectal cancer, improve the individualized precision treatment system, and avoid overtreatment and undertreatment. The treatment goal of low rectal cancer has shifted from simply emphasizing radical cure to balancing oncological efficacy and functional protection. By optimizing neoadjuvant treatment regimens, the tumor response rate can be improved. For patients with good regression after neoadjuvant treatment, the options of "watch and wait"/local resection may be available, thereby maximizing the preservation of organ function. This strategy is expected to gradually expand from locally advanced low rectal cancer to early‑stage low rectal cancer. Patients with early‑stage disease have a higher clinical complete response rate, thus meeting the demand for a high quality of life in early rectal cancer. For patients with poor tumor regression after neoadjuvant treatment, surgical intervention is required, and the choice of surgical timing is particularly important. Moni-toring molecular residual disease after colorectal cancer surgery through circulating tumor DNA and its methylation can realize risk stratification of non‑metastatic colorectal cancer, and is expected to detect recurrent and metastatic lesions earlier, improve the chance of secondary cure. Based on the research achievements of the multidisciplinary team for colorectal cancer in our center in recent years and some ongoing clinical studies, the authors discuss the optimization and innovation of the whole process management model for rectal cancer.