Objective To investigate the status and influencing factors of physical activity in rectal cancer patients with permanent colostomy,so as to provide reference for medical staff conducting targeted physical activity guidance and intervention for those patients. Methods A total of 286 rectal cancer patients with permanent colostomy were selected using convenient sampling, then they were investigated using the basic information questionnaire and the Chinese version of short International Physical Activity Questionnaire. Results Totally 45.80% patients had low level of physical activity, only 25.87% patients achieved guidelines recommended level of at least 150 minutes moderate to vigorous physical activity per week.Univariate analysis showed that, there were significant differences in standard reaching rate of guidelines recommended physical activity among the patients with different age, gender, personal monthly income, smoking, months after colostomy, and whether having colostomy complications （P＜0.05,P＜0.01）. Logistic regression analysis results indicated that, gender, personal monthly income, smoking and months after colostomy were the major influencing factors of reaching guidelines recommended physical activity among rectal cancer patients with permanent colostomy （P＜0.05,P＜0.01）. Conclusion Physical activity among rectal cancer patients with permanent colostomy is not good, especially in patients who are female, smoking, having middle-income and within 1 to 6 months after surgery. Medical staff should pay more attention to their physical activity, and develop personalized exercise prescription, so as to enhance their physical activity and improve physical rehabilitation.