Colorectal cancer is one of the most common malignant tumors of the digestive system, and rectal cancer has attracted extensive attention in clinical diagnosis and treatment. With the advancement of precision medicine, diagnostic and therapeutic strategies for rectal cancer continue to evolve. On March 5, 2026, the National Comprehensive Cancer Network (NCCN) released NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines?): Rectal Cancer (Version 1. 2026). This article systematically summarizes the key updates in this guideline and explores their implications for the clinical practice of rectal cancer in China, aiming to provide more precise and standardized references for the clinical diagnosis and treatment of rectal cancer.