Assess pre-operative (neo-adjuvant) chemo-radiotherapy for locally advanced rectal cancer. Follow-up continues until November 2019. The research required appropriate biochemistry, pathology, radiography, and medical/surgical management. Since June 2019, outpatients are assessed. Rectal cancer research studied age, sex, diagnosis delay, mortality, treatment options, death causes, surgical complications, and hospital stay. Typical, pre-validated, semi-structured case record proformas recorded the data. CBC, biochemical profile, serological sample, upright abdominal X-ray, CT scan, transrectal, pelvic, or abdominal ultrasound. After staging, patients received chemotherapy (625 mg/m2 capecitabine orally in 4 doses) and radiation (50.4 Gy in 28 parts) and were reevaluated for surgery after 4 weeks. Radiation was compared to dentate line distance. 30% pre-therapy lesions were 2–5 cm from the dentate line. 27.5% exhibited 5–10-cm dentate line lesions. Neoadjuvant chemotherapy altered distance. 25% exceeded 10cm. 6.48 (p=0.039). 1:10 men to women Participants averaged 59.87 and 14.56 years old. Neoadjuvant therapy increased the median lesion distance from the anal verge from 4.8 ±3.13 cm to 6.13 ± 2.11 cm. After neoadjuvant therapy, 52.5% of patients had anterior resection, 37.5% had LAR, and 10% had APR. However, more experience, higher-quality expertise, and more patients are needed to make the neoadjuvant method routine.