Aim of study — to evaluate the effectiveness of rectal artery embolization in the treatment of late postradiation hemorrhagic rectitis (PRHR). Material and methods. During 2015—2018 in MCRI named after P.A. Herzen 12 patients were observed with PRHR, degree G3 on the scale of RTOG/EORTC. The clinical manifestations of PRHR were evaluated before embolization and 6—12 months after embolization. Patients underwent arteriography of the lower mesenteric artery and embolization of the upper rectal arteries with a liquid embolitic PHIL agent. In case of unsatisfactory result, after embolization of the upper rectal arteries, the middle rectal arteries were embolized. All 12 patients underwent embolization of the upper rectal arteries. Only 4 patients required embolization of the middle rectal arteries, after which a hemostatic effect was achieved. Results. During the observation, 11 (91.67%) patients noted a progressive decrease in all clinical manifestations of the disease. In 1 (8.33%) patient, the clinical effect of the treatment was not achieved due to relapse of the primary tumor in the bladder, and therefore it was impossible to conduct a second course. The median follow-up was 26 months. During this period, clinically significant recurrence of bleeding was not recorded. Prior to treatment, in all patients, the severity of rectitis was regarded as G3, and 6 months after embolization, stage 4 was diagnosed in 4 (33.33%), which corresponds to recovery, degree G1 was diagnosed in 6 (50%), in 1 (8.33%) of the patient — G2. The average increase in hemoglobin level was 49 g/l, reaching an average value of 115 g/l, and this value was maintained throughout the observation, no episodes of bleeding recurrence were noted. Conclusions. Rectal artery embolization is an effective treatment option for PRHR, which significantly improved the quality of life in 91.67% of patients (median follow-up was 26 months), while traumatic surgical treatment can be avoided.