Villous adenoma is an unusual tumor of the colon, occurring largely in the rectum, that can usually be cured by adequate local excision. Over a five-year period, seven patients with villous adenoma of the retroperitoneal rectum and one poor-risk patient with adenocarcinoma were treated by posterior local excision of the tumor. All of them had large tumors with a wide base of attachment. Their average age was 67 years and they have been observed for an average of 36 months. There were no deaths and no substantial complications except a fecal fistula in one patient that required a temporary colostomy. One patient had a local recurrence of the benign villous adenoma after 47 months. The technique of posterior resection is simple and well tolerated. Posterior resection should not be used for adenocarcinoma of the rectum of a more radical procedure is possible.