OBJECTIVES: To evaluate the implementation of an integrated care pathway (ICP) for rectal cancer treatment in a Brazilian tertiary academic oncology hospital. METHODS: An ICP for rectal cancer treatment was implemented at Cancer Institute of São Paulo (ICESP), Brazil. A tumor board including oncologists, surgeons, radiation oncologists, radiologists, pathologists and nurses was established to standardize patient care, define the steps of the interventions and goals. Solutions to coordinate the steps were developed with administrative support: medical appointments and exams pre scheduling, sharing radiotherapy and chemotherapy appointment information and monitoring surgery interval after neoadjuvant treatment. Computerized reports and file-sharing programs facilitated team communication. A training program was established for healthcare managers and multidisciplinary team. A logic model was constructed to evaluate the implementation process. Time intervals between treatment steps were defined and measured for a cohort of patients from May12^th, 2011 through December 31, 2013 (named FGC20) and compared to a control cohort from May 06^th, 2008 through May11^th, 2011 (before ICP implementation – named PreFGC20).   RESULTS: The logic model identified 5 objectives: multidisciplinary team involvement, administrative support, solutions to accomplish the pathway, computerized tools to team communication and training. p< 0.001); interval between neoadjuvant step and surgery decreased 33% (PreFGC20: 22.2 weeks, FGC20: 14.8 weeks, p<0.001). Total time of treatment from initial medical appointment to surgery decreased 31% (PreFGC20: 278.2 days, FGC20: 191.8 days, p< 0.001). CONCLUSIONS: The logic model was useful to identify activities and point out obstacles and solutions for ICP implementation. The ICP promoted reductions in all time intervals between steps.