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Objective: Recent evidence suggests that Oct-4 is highly expressed in several cancers, and its expression contributes to tumor growth. In this study, we investigated the level of Oct-4 expression in rectal adenocarcinoma, and evaluated the prognostic significance of Oct-4 expression in these cases.Methods: The immunohistochemical expression of Oct-4 was evaluated in 52 formalin-fixed paraffin-embedded postoperative rectal adenocarcinoma tissue samples. The impact of the immunoreactivity of Oct-4 in regard to clinical outcome was determined by Kaplan-Meier and log-rank.Results: The expression level of Oct-4 ranged from 0 to 18.5%. There was no significant association between Oct-4 expression and gender (P=0.772), age (P=0.123), clinical stage (P=0.391), and histological grade (P=0.056). The 3-year local recurrence-free rates with negative and positive expression of Oct-4 were 83.5% and 75.0%, respectively (P=0.583). The 3-year metastasis-free rates with negative and positive expression of Oct-4 were 88.6% and 61.9%, respectively (P=0.035). The 3-year overall survival rates with negative and positive expression of Oct-4 were 77.9% and 49.0%, respectively (P=0.037).Conclusion: The results suggest that embryonic stem cell marker Oct-4 expression may have prognostic significance in patients with rectal adenocarcinoma. However, to confirm this more and larger studies are required.