Pathological lymph node yield can be influenced by multiple factors. The use of ex-vivo MR guided pathology of rectal specimens could provide insight in the number and size of lymph nodes present in a rectal specimen and aid in an increased pathological lymph node yield. Therefore two series of rectal specimens were examined, one control group and one MR-guided group. Ex-vivo MRI revealed significantly more and significantly smaller lymph nodes without increasing the pathological yield. Small nodes appear to be difficult to harvest, presumably requiring a 3D approach for further improvement of pathological evaluation.