With the extensive clinical implementation of total mesorectal excision (TME) and neoadjuvant therapy, the probability of local recurrence after rectal cancer surgery has been significantly reduced, but some patients still have a recurrence in the surgical field and lateral lymph node areas after radical surgery, which seriously affects the quality of life of patients. It is one of the main causes of death of patients. With the continuous advancement of multidisciplinary cooperation and diagnosis and treatment concepts, locally recurrent rectal cancer has gradually attracted the attention of colorectal surgeons. This article reviews the predictive factors, incidence patterns, and local recurrence radical resection based on total pelvic resection. Such as total sacral resection, combined resection of iliac vessels and other radical surgical attempts.