Background: Magnetic resonance imaging (MRI) is used for preoperative local staging in patients with rectal cancer. Our aim was to retrospectively study the effects of the imaging protocol on the staging accuracy.Patients and methods: MRI-examinations of 26 patients with rectal carcinoma were done pre-operatively before surgical resection or neoadjuvant therapy. Rectal cancer imaging protocol was defined as including T2-weighted imaging in the sagittal and axial planes with supplementary coronal in low rectal tumors, alongside a high-resolution plane perpendicular to the rectum at the level of the primary tumor. Histopathological results were used as gold standard for comparison with the results of the MRI.Results: Rectal imaging protocols showed significantly better correlation with histopathological results regarding assessment of rectal wall invasion, lymph nodes affection, sphincter infilteration and anterior organ involvement. Conclusion: Appropriate MR imaging protocols enable more accurate local staging of rectal tumours with less number of sequences and without intravenous gadolinium contrast agents with determination of the methods of treatment preoperatively as radical resection either low anterior resection or abdominoperineal resection or neoadjuvant chemo-radiotherapy.