A 68-year-old man was seen at the hospital because of perineal pain lasting from June 2002. There were previous histories of undergoing a low anterior resection of the rectum for rectal cancer at the age of 52, and undergoing an abdominoperineal excision of the rectum for recurrence of the rectal cancer at the anastomosis at the age of 54. This time, abdominal and pelvic CT scans visualized a tumor 5cm in diameter on the left side of the pelvis and the left ureter which was involved by the tumor, presenting left hydronephrosis. Local recurrence of the rectal cancer with invasion into the bladder and ureter was diagnosed. Removal of the tumor with associated resection of the bladder, prostate, and ureter was carried out. And an ileal conduit was made. Pathological findings were compatible with those of recurrence of the rectal cancer. Local recurrence of rectal cancer 16 years after surgery for the primary lesion was definitely diagnosed.