With the advancement of medical technology and surgical techniques, postoperative recurrence of rectal cancer is no longer a contraindication of surgery, and patients can still obtain a great survival prognosis after radical resection. However, due to the low R0 resection rate of locally recurrent rectal cancer and the need to improve long-term survival, surgical resection alone is not suitable for most of these patients, and the patients after multiple-organ resection are frail, have poor tolerance, and have few opportunities to receive adjuvant chemotherapy/radiotherapy. Therefore, more and more scholars have added neoadjuvant therapy to the treatment of such patients. This article summarizes the research progress of neoadjuvant therapy and its indications, neoadjuvant therapy combined with hyperthermia for locally recurrent rectal cancer.