Objective: To explore the efficacy and safety of bevacizumab combination in neoadjuvant therapy in the middle and low locally advanced rectal cancer. Methods: Middle and low locally advanced rectal cancer patients who treated by bevacizumab and FOLFOX combination with neoadjuvant radiotherapy as the observation group , and the patients treated by FOLFOX combination with neoadjuvant radiotherapy as the control group. The pathological complete response rate, tumor downstaging rate, anal sphincter preservation rate, the incidence of adverse events and perioperation complications were compared between the two groups. The SPSS 23.0 software was used to data analysis and P <0.05 was thought to be statistical significance. Results:There was no significant difference between the two groups in the rate of The pathological complete response rate, tumor downstaging rate and anal sphincter preservation rate（p>0.05）.Conclusions:Bevacizumab combined with neoadjuvant therapy was well tolerated in the treatment of middle and and low locally advanced rectal cancer, it did not obviously increase the adverse events of neoadjuvant therapy and perioperation complications. However, the pCR rate, tumor down staging rate and sphincter preservation rate was not improved in the comparison to the other trials that used FOLFOX in preoperative radiochemotherapy.