BACKGROUND: The prognosis of rectal cancer is closely related to its clinicopathologic features. Accurate preoperative assessment of these features is crucial for treatment planning and prognosis prediction. The apparent diffusion coefficient (ADC), derived from diffusion-weighted imaging (DWI), has shown potential as a noninvasive imaging biomarker for evaluating tumor characteristics. This study aimed to explore the relationship between ADC values and the clinicopathological features of rectal cancer. METHODS: We retrospectively recruited 97 eligible patients with rectal adenocarcinoma who underwent magnetic resonance imaging (MRI) and surgical resection at our institution between January 2023 and December 2023. Each patient was evaluated for the presence of extramural vascular invasion (EMVI) or circumferential resection margin (CRM) on MRI, and the mean (ADC RESULTS: Among 97 patients with rectal cancer, the mean age was 61.40±10.46 years and 60 (61.9%) were males. ADC CONCLUSIONS: ADC values were negatively associated with different clinicopathological features of rectal cancer, suggesting their potential role as noninvasive imaging markers for preoperative tumor assessment.