Abstract: Although, the clinicopathologic features of Solitary Rectal Ulcer Syndrome (SRUS) are well documented, the heterogeneous histologic features of lesions that the syndrome produces and its rare incidence may make for histologic misdiagnosis. The retrospective descriptive study was performed on patients presenting to No. 3 Special Pathology Laboratory of Tabriz Medical University from 1999-2000. There were 5 patients with SRUS. There were 5 patients (3 males and 2 females) whit age range of 15-75 years. Of all cases, SRUS had been considered only in one case as clinical differential diagnosis. The patients had no history of previous important disease in their family. Their manifestations were anal pain and itching, anorectal pain and feeling of incomplete emptying, mild rectal bleeding at the end of defecation. SRUS is often underdiagnosed condition. It is often misdiagnosed as other digestive diseases such as cancer or inflammatory bowel disease. The diagnosis requires a high index of suspicion on the part of both the clinician and the pathologist. Also, serial cutting and examination of all slices is an important help for both pathologist and patient.