ObjectiveTo assess the effect of adjuvant chemotherapy for patients with rectal cancer. MethodsThe related randomized controlled trials comparing patients underwent radical surgery for rectal cancer with (adjuvant chemotherapy group) or without (surgery alone group) adjuvant chemotherapy, were retrieved from the databases such as PubMed, Cochrane Library, EMBAS, CBM, CNKI, WanFang, and VIP, then using RevMan 5.2 software to conduct the Meta-analysis. ResultsA total of 8 articles involving 3 654 patients were included. The results of Meta-analysis showed that:①for all patients with rectal cancer, the 2-(OR=1.28, 95% CI: 1.05-1.57, P=0.020), 3-(OR=1.28, 95% CI: 1.09-1.51, P=0.003), and 5-year (OR=1.21. 95% CI: 1.05-1.40, P=0.008) survival rates of adjuvant chemotherapy group were higher than those of surgery alone group, respectively.②For patients with rectal cancer ofⅡstaging, compared with surgery alone group, the 5-year survival rate was higher in adjuvant chemotherapy group (OR=1.39, 95% CI: 1.09-1.78, P=0.009), but 5-year recurrence rate was lower in adjuvant chemotherapy group (OR=0.65, 95% CI: 0.49-0.87, P=0.003).③For patients with rectal cancer ofⅢstaging, compared with surgery alone group, the 5-year recurrence rate was lower in adjuvant chemotherapy group (OR=0.40, 95% CI: 0.26-0.64, P=0.000 1), but there was no significant difference on the 5-year survival rate (OR=1.27, 95% CI: 1.00-1.61, P=0.050). ConclusionCompared with radical surgery, radical surgery combined with postoperative adjuvant chemotherapy can improve the survival and reduce the recurrence for patients with rectal cancer.