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BACKGROUND: In order to improve the clinical results of rectal cancer, hyperthermia has been prescribed in combination with chemotherapy and radiotherapy. The techniques of hyperthermia and their clinical applications to rectal cancer were reviewed. METHODS: The development of heating devices has been intensively investigated, including external heating devices, intraluminal heating devices, circulation of warmed saline solution, and whole body hyperthermia. RESULTS: Nonrandomized and randomized trials for rectal cancer have demonstrated an improved local response with the combined use of hyperthermia and conventional treatments. A preoperative therapy with hyperthermia increased resectability and decreased local recurrence, resulting in the improvement of the postoperative prognosis. There were no major postoperative complications related to the preoperative treatment.