OBJECTIVE： To observe the influence of capecitabine combined with radiotherapy on postoperative survival rate， relapse rate and survival quality of elderly patients with rectal cancer at Ⅱ-Ⅲ stage. METHODS： 110 patients with rectal cancer at Ⅱ-Ⅲ stage were selected and randomly divided into control group and observation group with 55 cases in each group. Both group received radical resection of rectal carcinoma. Control group was given three dimensional conformal radiation therapy （3DCRT） after operation； observation group was additionally given capecitabine 1 500 mg/m2， d1-14， qd， on the basis of control group. A treatment course lasted for 21 d， and both groups received 2 courses of treatment and followed up for 3 years. The survival rate and metastasis and recurrence rate of 2 groups were compared as well as KPS score before and after treatment. Toxic reaction of 2 groups was also observed. RESULTS： The follow-up total survival rate and disease-free survival rate of observation group were 89.09％ and 76.36％， which were significantly higher than 74.55％ and 54.55％ of control group； the distant metastasis rate and local recurrence rate were 12.73％ and 5.45％， which were significantly lower than 30.91％ and 21.82％， with statistical significance （P＜0.05）. KPS score of 2 groups were increased significantly， between 2 groups before and after treatment ，with statistical significance （P＜0.05）； Comparison between groups （P＞0.05）. There was no statistical significance in the incidence of nausea and vomiting， diarrhea and urinary tract reaction between 2 groups （P＞0.05）； but the incidence of bone marrow arrest in observation group was significantly higher than control group（P＜0.05）. CONCLUSIONS： Capecitabine combined with 3DCRT can effectively improve postoperative distant survival rate of patients with rectal cancer at Ⅱ-Ⅲ stage， and reduce the metastasis and recurrence risk； do not lower life quality and induce serious adverse reactions.