Preoperative selection is the key to appropriate therapy for rectal cancer. The authors point out the advantages of magnetic resonance imaging with external phase-arrayed coils as an alternative after ultrasound failure for bulky lesions, strictures, low tumors, and locally advanced disease. Using this technique, it was possible to achieve excellent sensitivity, specificity, and overall accuracy in a series of consecutive patients. Even for malignant lymphadenopathy, 70% accuracy was obtained. With the advent of newer contrast media specifically for the lymphatic system, or in combination with positron emission tomographic scanning, we may possess the ideal staging tools.