The objective of this study was to evaluate the feasibility, safety and diagnostic accuracy of transrectal ultrasound (TRUS)-guided core biopsy for recurrent carcinoma of the uterine cervix in patients with non-diagnostic vaginal cytology and transvaginal punch biopsy.17 patients with clinical and imaging suspicion of recurrent carcinoma of the cervix, and with negative cytology and punch biopsy, were referred for TRUS-guided biopsy of a recurrent mass. Data were collected with respect to demography, previous diagnosis, treatment received, size and location of the recurrent lesion, and biopsy results. Adequate samples were obtained for all patients. TRUS-guided biopsy was technically successful in all of the patients and provided histological diagnosis of recurrence in 16 patients. One of the patients had post-radiation fibrosis. There were no procedure-related complications. In conclusion, TRUS-guided biopsy for recurrent cervical cancer is a feasible, safe and accurate method for establishing a histopathological diagnosis. It should be considered in patients with non-diagnostic vaginal cytology and punch biopsy.