Rectal cancer with perianal abscess as the first manifestation is rare. For patient with such a situation, 'anal pain' is often their primary complaint. As a result, such a condition is easily misdiagnosed as simple perianal abscess while the underlying rectal cancer is missed. This is particularly true when the rectal lesion is small and superficial. Recently, a case of lower rectal cancer complicated by perianal abscess was admitted to the Department of Gastrointestinal Surgery of Affiliated Hospital of Jiangnan University. A multidisciplinary team was formed to diagnose and treat this patient, and the outcome was satisfactory. The current report aims to describe the diagnosis and treatment process adopted by this team and illustrate the advantage of such an approach.