A solitary rectal ulcer is a chronic ulceration of the rectum that may be mistaken for malignancy. Symptoms include bleeding and the passage of mucous on defecation. Ulceration most commonly is found on the anterior rectal wall. Misplaced mucosa and lamina propria in the submucosa may be confused with adenocarcinoma. Management options include fiber, biofeedback behavioral retraining, and surgery.