Solitary Rectal Ulcer Syndrome (SRUS) is a rare defecation disorder with varied clinical manifestations and often presents challenges in diagnosis. To date, there is no definitive treatment for SRUS. However, there is consensus that treatment should be individualized, multimodal, and focused on addressing potential causes of the disease. Surgery is reserved for correcting anatomical problems. This review provides an update on available data regarding the pathophysiology, presentation, clinical evaluation, and various treatment alternatives.