Introduction. Chemotherapy administered concurrently withradiotherapy for locally-advanced rectal cancer prior to surgeryis a standard of care approach. A fraction of patients after chemoradiotherapyachieve pathological complete remission. Our aim wasto evaluate patients treated only with a non-operative approach ofonly chemo-radiotherapy followed by observation at a communitycancer center.Methods. Medical charts of the patients who were treated for locallyadvanced rectal cancer and treated with chemo-radiation therapyalone from January 1, 2000 through May 1, 2017 at a Midwesterncancer center were reviewed. The clinical course of the patients wasfollowed from the time of the cancer diagnosis through their last availableclinical record.Results. A series of three cases were reviewed with locally-advanceddistal rectal cancers treated with a non-operative approach.Conclusions. Watchful waiting for patients with locally advanceddistal rectal cancer who have complete clinical response with neoadjuvantchemotherapy and radiation might be an effective treatmentstrategy. Kans J Med 2019;12(1):17-19.