Abstract： Objective To evaluate the long-term efficacy of endoscopic excision for rectal carcinoids.Methods Clinical data of 91 patients with rectal careinoids treated by endoscopic excision from 2000 to 2007 were analyzed retrospectively.Results The average size of the primary tumor was 0.8 cm (range 0.3 to 2.3 cm). All the tumors were localized within the submucosal layer showing typical histology without lymphatic or vessel infiltration. Follow-up was available for 80 patients with mean 32.5 months (range 6 to 96 months). There was no recurrence in 65 patients with tumor size ＜ 1.0 cm.Recurrence occurred in 3 cases among 25 patients with tumor size from 1.0to 2.0 era,and 1 died of hepatic metastasis.The 1-,3-,and 5-year survival rates of the patients were 100%,98.0%,and 91.4% respectively.Conclusions Tumor size and depth of invasion are two important prognostic factors of rectal careinoids. Endoscopic excision is useful for rectal careinoid patients with tumor size ＜ 1.0 cm and located within the submucosal layer.