Aim: The purpose of this paper is to present some of the challenges found to be problematic in recruiting individuals following sphincter saving surgery for rectal cancer for a multicentre study. While the focus of the study is on symptom experiences and management of bowel symptoms following colo-rectal surgery, the paper will concentrate solely on the challenges experienced in recruiting a sample for the study. Background Recruitment of an adequate number of participants is a challenge for researchers in any area of research involving patients. Enrolment of patients treated for rectal cancer poses particular challenges because the total population of this group in a given country can be small. The use of multiple centres was required to obtain the required number of participants for the current study. Findings: In multicentre studies, researchers can encounter substantial challenges in obtaining ethical approval, accessing clinical sites and gaining direct access to patients. These challenges are embedded in a convoluted process involving many systems of communication, which can vary from one centre to another. Conclusions: The process of obtaining ethical approval is prolonged in the absence of a central ethical review committee. A review process based on a standard application for researchers seeking ethical approval for multi- centred studies central is necessary. Establishing and maintaining access to clinical sites requires co-operation from many individuals during the development of the proposal and continuing throughout the data collection process.