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The authors review their five-year experience of solitary rectal ulcers. A revision of the most recent literature enables them to outline the characteristics of the disease with reference to its epidemiology, anatomopathology and clinical features. The discussion focuses on the problem of treatment which must be based on a thorough and in-depth knowledge of pathogenetic mechanisms. The paper outlines two theories, the hamortomatous one and the so-called mechanical theory involving the hinge valve, which are referred to by most researchers. The question of treatment is then discussed illustrating the possibility of resorting to surgical-type treatment which appears to be the most suitable for the definitive resolution of the problem. But since, at least in the light of the authors' personal experience; the majority of patients belong to an age group in which other pathologies are often present, the medical treatment option appears to be more rational. The re-education of the alvus achieved using suggestions not only of a dietary type but also regarding the behaviour and correct position to assume during defecation appears, at least theoretically, sufficient to obtain a marked improvement. The local application of therapeutical AIDS, if necessary strengthened by the action of drugs taken systemically, brings considerable further benefit to the patient who cannot and/or does not which to undergo surgery.