Aim: In this study, the efficacy of rigid rectoscopic examination compared to flexible colonoscopy for the differential diagnosis of the patients who had a bright-red, usually minimal rectal bleeding that smeared the surface of the stool and had no juvenile polyps determined by the rectal examination was evaluated, Method: 47 patients admitted with rectal bleeding between 1994-2002 were included in the study. The patients were evaluated in two groups: according to the history, physical examination and the investigation by rigid rectoscopy until 1999 in the first group (n=24), and flexible video-colonoscopy between 1999-2002 in the second group (n=23). Results: Digital rectal examination determined the juvenile polyp and transanal polypectomy was performed in 11 patients of the first, and 7 patients of the second group. The rigid rectoscopic examination was done in 13 patients with rectal bleeding in the first group, and the polyp was found only in one patient. In the second group, the flexible video-colonoscopy showed the polyp in 6 patients out of 16 examinations. These polyps were not determined by digital rectal examination and localized on the proximal rectum and the upper parts within the distance of 15 to 50 cm from the anal verge. The polyps were cauterized and removed by snear. The other pathologies including neutropenic enterocolitis in one patient, hemangioma in another one and internal hemorrhoids in two other patients were also determined by colonoscopic examination. Conclusion: For rectal bleeding, following the detailed history received with the questions on constipation, enteritis and parasite in stool, rigid rectoscopic examination performed in patients who have no significant pathology found during the perianal inspection and digital rectal examination can not efficiently substitute for flexible colonoscopy in the diagnosis and the management.