Abstract: Objective To investigate the clinical significance and prognosis about expression of tissue inhibitor of metalloproteinase-1 (TIMP-1) in rectal cancer. Methods The expression of TIMP-1 in 40 samples of rectal cancers and 30 normal rectal mucosa was examined using immunohistochemistry. The relationship of their expression with some clinicopathological characteristics and prognosis was analyzed. Results The positive expression rate of TIMP-1 (62.5%) was higher in rectal cancer than normal rectal mucosa. Increased TIMP-1 expression was significantly correlated with tumor differentiation, Dukes stage and lymph nodes and distant metastasis. Compared with the cases of negative TIMP-1 expression, the patients with positive TIMP-1 expression had a significantly higher 5-year survival rate(P<0.05). Conclusions TIMP-1 may play a key role in rectal carcinogenesis, tumor invasion and metastasis. TIMP-1 is a allergy indicator for diagnosis of rectal cancer with high specificity. The expression of TIMP-1 is directly correlated with the invasion and metastasis of rectal cancer and prognosis.