Introduction; Radical surgical approach to rectal cancer and other pelvic organ cancers have a significant morbidity but impressive results in improvement in loco–regional control of disease. Although, with the advancement of non–surgical modalities of treatment, the outcome has increased but the surgical resection remains the only curative option with the best results in both primary locally advance and localize recurrent rectal cancer. Additional, the symptom control in these patients can be achieved with the resection only with the acceptable morbidity. Material and methods; A total of 43 patients underwent pelvic exenteration surgery (total, anterior or posterior) at our institute, categorised in two groups as, Group I rectal cancer and Group II non–rectal cancer. In all patients, intra–operative and post–operative parameters including operative time, blood loss, level of resection satisfaction, haemorrhagic or serosanguinous or serous or purulent, post–operative recovery and early complications were noted. Survival was observed as disease free survival and overall survival. Results; Median age of patients was 49 and 47 years in group I and II respectively. Operative time and intra–operative blood loss was higher in non–rectal cancer patients, but statistical non–significant. The level of resection (R0) was better in group I as 64% vs 55% (p=0.001). Overall post–operative complications were more in group II. Oncological outcome including DFS and OS was better in group I but statistical non–significant. The results were comparable between retrospective and prospective groups. Patients with primary disease had favourable results compared to recurrent disease. Conclusion; Pelvic exenteration surgery is a feasible treatment option in locally advanced pelvic organ malignancies with a satisfactory long term outcome, and acceptable morbidity. Patients with rectal cancer, especially with primary tumours have better outcomes as compared to other pelvic organ origin cancers. The overall outcome depends on patient selection, completeness of resection, and comprehensive perioperative care.