There are no established treatment protocol for isolated lateral lymph node recurrence in patients with T1 lower rectal cancer, because such case is very rare. In our institution, this is the only recorded case of lateral node recurrence post-resection. It has been documented in several studies that salvage surgery for colorectal cancer improves prognosis. However, there were only 3 reported cases found for lateral lymph node metastasis from colorectal cancer that underwent excision. In this study, we report a rare case of lateral lymph node recurrence after trans-anal resection for T1 lower rectal cancer wherein we performed laparoscopic right lateral pelvic lymph node dissection. The procedure was done safely without any complications. No recurrence noted on follow-up. Hence, we can perform resection of isolated lateral lymph node recurrence in selected patients to achieve good prognosis.