['Achieving a pathologic complete response (pCR) after neoadjuvant therapy has been associated with better prognosis in rectal cancer patients. The objective of this study was to investigate the relationship between distance to the anal verge (DTAV) and pCR.', 'Review of a prospectively maintained database of patients with locally advanced rectal cancer who received neoadjuvant treatment was completed. Uni- and multivariate analysis assessed the association between DTAV and pCR after neoadjuvant therapy.', 'Of 827 included patients, 20% had a pCR. We found that pCR rates were 11% for tumors <4\u2009cm, 24% for tumors 4-6\u2009cm, 30% for tumors at 6-8\u2009cm, 17% for tumors 8-10\u2009cm, and 14% for tumors >10\u2009cm from the anal verge (P\u2009=\u20090.002). Multivariate analysis also showed a strong association between DTAV and pCR (P\u2009=\u20090.008). The bimodal distribution of pCR resulted in a lower odds ratio of pCR for tumors <4 and >8\u2009cm from the anal verge.'] Is distance to the anal verge associated with pathologic complete response to neoadjuvant therapy in locally advanced rectal cancer?