The gastrointestinal neuroendocrine neoplasms (GI-NENs) are very rare, among which second most common type is the rectal NENs in China. Patients with rectal NENs may experience non-specific symptoms such as pain, perianal bulge, anemia, and bloody stools, and surgery is considered as the first treatment for rectal NENs. We report a case of rectal NENs in a 68-year-old male patient with bloody stools, who received surgery and postoperative pathology revealed an elevated well-differentiated neuroendocrine carcinoma.