Background. Rectal cancer constitutes about one third of all gastrointestinal tumor. High-resolution MRI is the best method of assessing the relation of the rectal tumor with the potential circumferential resection margin (CRM). Therefore it is currently considered the method of choice for local staging of rectal cancer. The primary surgery of rectal cancer is total mesorectal excision (TME), which plane of dissection is formed by the mesorectal fascia surrounding mesorectal fat and rectum.This fascia will determine the circumferential margin of resection. Objective. The purpose of this study was to assess the accuracy of MRI in the preoperative staging, prediction of negative circumferential resection margin and planning of surgical management of rectal carcinoma.Subjects and Methods. Seventy five patients (30 men, 45 women) with pathologically proven rectal carcinoma underwent MRI study with trans-rectal gel administration. Conclusion. MRI of rectal cancer is accurate for preoperative staging, prediction of negative circumferntial resection margin, lymph nodes involvement and planning the feasibility of sphincter-sparing surgery.