Objective：To systematically review the efficacy and safety of radiotherapy combined with hyperthermia（HRT） for rectal cancer，and to provide the reference for clinical practice and research. Methods：Foreign databases of Cochrane Library，PubMed，EMBASE，Web of Science and Chinese databases of CBM，CNKI，VIP and WanFang were searched with computer and other sources were also retrieved. All relevant randomized controlled trials（RCTs） were collected to compare HRT and radiotherapy alone（RT） for rectal cancer. After literature screening，data extraction and quality evaluation were performed by authors according to the protocal，the meta-analyses were conducted using the RevMan 5.3 software. Results：Eight RCTs were included with 573 patients involved. Meta-analysis showed：①The 2，3，4-year survival rate，complete response rate，total effective rate and symptoms improve rate were higher in HRT group than in RT group，with significant differences（P<0.05）. The RR value and 95%CI were （RR=1.50，95%CI=1.10 to 2.06），（RR=1.77，95%CI=1.06 to 2.98），（RR=1.82，95%CI=1.04 to 3.17），（RR=2.55，95%CI=1.55 to 4.19），（RR=1.62，95%CI=1.34 to 1.96），and（RR=1.18，95%CI=1.03 to 1.34），respectively. ②The incidences of acute toxicity was lower in HRT group than in RT group，without significant difference（P=0.05）. The RR value and 95%CI were （RR=0.72，95%CI=0.51 to 1.00）. Conclusion：Compared with radiotherapy alone，HRT can improve long-term survival rate and short-term curative effect，therefore，it is safe and feasible. However，due to the limited quantity and quality of the included studies，more high quality studies with large sample size and long-term follow-up are still needed to verify the above conclu－sion.