Colorectal cancer is a frequent cancer in both sexes, representing 13% of all cancer cases. Surgery still remains the main modality in rectal cancer treatment The literature is inconclusive regarding the real value of preoperative irradiation. The aim of this study is to assess the influence of preoperative hyperfractionated radiotherapy (5x5 Gy) on local and systemic recurrence rate in patients with rectal cancer operated according to TME technique. Local recurrence occurred in 4.4% of patients after preoperative radiotherapy and in 12.4% of patients undergoing only surgical treatment (p=0.017). Both groups had similar systemic recurrence rate (7.4% vs. 10.2% respectively, p=0.403). Lower rate of systemic recurrence was observed in patients operated on 4-5 weeks after the end of irradiation (2.8% vs. 12.3% in the subgroup with shorter interval, p=0.035). Survival analysis during 3-year follow-up showed no increase in overall survival in patients with combined treatment (radiotherapy + surgery). Overall survival in this group was 80% vs. 78% in control group (p=0.847). When time interval between irradiation and operative treatment was longer (4-5 weeks) 3-year survival was 85% vs. 77% in the subgroup with short interval (p=0.379). Statistically significant increase in overall survival was observed only in patients with downstaging after radiotherapy – 95% in comparison with 78% in patients operated on without previous radiotherapy (p=0.036).