Oncology in general has seen vast advancements over recent years. Improved und- standing of tumor biology, multidisciplinary team decisions and an individualized therapy are cornerstones of treatment planning for cancer patients today. These dev- opments have challenged the imaging community with ever more specifc questions on tumor detection, staging and therapy control. Whereas this evolution applies to many tumor entities, rectal cancer takes an outstanding role, as it was the recognition of certain anatomical and pathological features of the disease, with the help of magnetic resonance imaging (MRI), that induced radiology not only to aid in disease mana- ment, but in fact to be a powerful engine for new concepts in rectal cancer treatment. The continuous improvement of highly specialized MRI and the groundbreaking scientifc contributions of radiologists all over the world have paved the way for s- stantial refnements of this technique during the last decade. Consequently, dedicated imaging protocols for routine diagnostic work-up of r- tal cancer patients are now available, which can guide multidisciplinary team de- sions and, in combination with optimized surgery and chemoradiotherapy, lead to longer survival and a better quality of life. Besides the scientifc advances, the enduring clinical success of MRI in the feld of rectal cancer is highly contingent upon expertise. To this end, ongoing education and continuous training are vital.