The rectal examination is a much advocated procedure for assessing abdominal and urinary symptoms. A Medline literature search yielded only a few studies, not one of them in a general practice setting. The sensitivity of the rectal examination to rectal carcinoma and appendicitis is low, while it is high for prostate carcinoma. When reviewing the likelihood ratios of normal and abnormal findings of rectal examinations it was concluded that it may be a useful procedure in the case of abnormal findings in patients presenting rectal problems and in assessing men with prostate problems, although it does not seem useful in diagnosing appendicitis. However, since the diagnostic values in general practice and in referred populations may be different, there is a need for further prospective studies in settings of general medical practice.