Complete response to chemoradiotherapy for rectal cancer is becoming a common clinical entity. Techniques to diagnose complete response and how to survey these patients without operative intervention are still unclear. We review the most recent evidence. Barriers to firm conclusions regarding this are heterogeneity ofdiagnostic definitions, differing surveillance protocols, and a lack of randomised studies. Complete response to chemoradiotherapy for rectal cancer is becoming a common clinical entity. Techniques to diagnose complete response and how to survey these patients without operative intervention are still unclear. We review the most recent evidence. Barriers to firm and compliance are this hetero heterogeneous of diagnostic definitions, differing surveillance protocols, and a lack of randomized studies.