AIM:To study the local recurrent rate and the causes of rectal cancer after surgery.METHODS:The clinicopathological data of 213 rectal cancer patients and the follow-up information were analyzed. The overall recurrent rate and the recurrent rates from different surgical appreaches were calculated. The main causes of recurrence were investigated.RESULTS:Among the 213 cases, 73 (34.27%) had local recurrence. The recurrent time ranged from 3 months to 62 months after the first operation. Most of the recurrence (65/73, 89.04%) occurred within 3 years after operation.CONCLUSION:Local recurrence had no significant correlation with surgical methods or pathological types, but closely related to Dukes' stages, location of primary tumors and the length of the distal rectum resected. Early resection and a wide tumor free resection margin are key factors to prevent local recurrence.