With the development of cancer genomics, emergency of biological technology, imaging diagnosis and surgical techniques, cancer patients with preoperative accurate diagnosis of clinical staging and molecular biology information have made personalized treatment possible. The surgical treatment of rectal tumor is gradually moving towards the era of ″precision medicine″. Based on the standard radical surgery, the precise cancer surgery included accurate diagnosis of tumor types and stages by modern imaging and molecular pathological techniques, detailed therapeutic strategy before surgery, minimally surgical trauma and maximally preserving organ function by the latest surgical techniques and quickly promoting the rehabilitation of patients. Here, we discussed the significance and clinical practice of precision medicine in colorectal cancer radical surgery that would promote the prevention and control of gastrointestinal cancer in our country.