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Context: Colorectal cancer is the fourth leading cause of cancer death worldwide. Aim: The study aim was to describe an endosonographic feature of rectal cancer in Iranian patients. Settings and Design: A retrospective study in Mehrad Hospital, Tehran, Iran. Materials and Methods: In this case series, all patients with confirmed diagnosis of rectal cancer during 2012-2014 were included and their hospital records were reviewed. Results: Hospital records of 76 patients with rectal cancer including 44 male (57.9%) and 32 females (42.1%) were reviewed. The mean age of patients was 57.81 ± 14.26 years. The distal rectum was the most common location of the tumor (42 patients, 55.3%) and complete luminal obstruction was observed in 11 patients (14.5%). Sphincters were free of disease in 70% of patients (53), while lymph nodes were involved in more than 70% of patients at diagnosis. Internal anal sphincter (IAS) alone was the most common sphincter involved (16 patients, 21%) followed by involvement of all three sphincters together (IAS and external anal sphincter and longitudinal muscle) (5, 6.6%). Conclusion: The mean age at diagnosis of rectal cancer in our country is less than that of Western countries. Lower rectum is the most common location of rectal cancer in our patients and lymph node metastasis is present in more than 70% of patients at the time of diagnosis.