Background: rectal cancer constitutes about one third of all gastrointestinal tumor. High resolution MRI plays a pivotal role in the post-operative follow up and also plays an important role in detection of recurrence. It is the best modality to assess the relations of the rectal tumor and the potential circumferential resection margin (CRM). Therefore it is currently considered the method of choice for local staging of rectal cancer and follows up after total mesorectal excision (TME) and detection of residual or recurrent cancer. Objective: the purpose of this study was to assess the accuracy of MRI in the postoperative assessment rectal carcinoma and detection of recurrence. Subjects and methods: twenty patients with pathologically proven rectal carcinoma underwent pelvic MRI examination. Results: this study was conducted on twenty patients (13 male and 7 female) who underwent surgical excision of pathologically proven cancer rectum. Patients were selected from outpatient's clinic and Department of Surgery at the El-Demerdash Hospital. The patient's age ranges from 32 to 75 years old. Conclusion: MRI of rectal cancer was accurate for post-operative assessment and had high sensitivity with specificity in the detection of recurrence.