Multidisciplinary team meetings (MDTMs) have been implemented to deal with the complexity of cancer care. The organization of the MDTM is time consuming and comes with costs. MDTMs across the Netherlands can deal with the majority of patients with pelvic cancer from gastroenterological, urological, or gynaecological origin. Patients with locally advanced and recurrent pelvic cancer should be discussed in a specialized MDTM. Patients with advanced primary and recurrent pelvic cancers form a group distinctly different from T1–3 primary cancers, who are treated in the majority of regional and university-affiliated hospitals with excellent results. Radiologic assessment of local and distant disease in the setting of advanced pelvic cancer can be challenging. Therefore, all diagnostic imaging is assessed by radiologists and nuclear medicine physicians with specific expertise in cancer imaging prior to the MDTM. Increased complexity of modern cancer care requires a multidisciplinary approach.