Postoperative perineal hernia is a rare complication after abdominoperineal resection or pelvic exenteration. In this video article, we describe one technique of transperineal mesh repair of recurrent symptomatic perineal hernia after previous transabdominal mesh repair of the hernia developed after abdominoperineal resection. To date, this redo mesh repair is the only report that we could find in the English literature.