How to select patients likely to benefit from reoperation? When a neoadjuvant treatment is still feasible, is it useful to perform preoperative radiation or chemoradiation? What can be expected after resection of local recurrences in terms of survival and quality of life? Does surveillance of patients operated for rectal carcinoma influence resectability of local recurrences and results? These are the main questions concerning the management of local recurrences after resection of a rectal carcinoma.