We examined 40 cases of locally recurrent rectal cancer surgically treated at our hospital. The sites of recurrence were the anastomosis site(16 cases), pelvic lymph nodes(10 cases), pelvis(10 cases), and perineum(5 cases). Intraoperative complications were confirmed in 5% and postoperative complications in 45% of cases. The R0 resection rate was 60.0%, and positive radial margins were confirmed in 35.0% of cases. Second recurrences were confirmed in 60.0% of cases. The 3-year overall survival rate was 68.7%, and the 3-year relapse-free survival rate was 20.3%. Surgery for locally recurrent rectal cancer was performed relatively safely; however, the R1 resection rate and recurrence rate after surgery were high. R0 resection significantly improved the overall survival rate, and it seems that a treatment strategy to raise R0 resection rate is necessary.