The incidence and mortality of rectal cancer remain high in China. Standardized preoperative regimen of neoadjuvant chemoradiotherapy and total mesorectal excision has significantly reduced the risk of local recurrence of rectal cancer, but has not improved overall survival(OS). At present, radiotherapy has been shown to affect anal function, urination function, and sexual function. To minimize treatment-related toxicity and improve OS, reoperation with neoadjuvant chemotherapy without radiotherapy may be a better option. This review aimed to clarify the research status and feasibility of neoadjuvant chemotherapy in locally advanced rectal cancer.