Loco-regional recurrences are the most common type of postsurgical relapse of rectal and sigmoid carcinoma. The authors report on 108 consecutively treated patients: site, clinical features and symptoms of the recurrences are considered together with treatment results. A symptomatic effect was generally achieved with 35 to 45 Gy, while higher doses did not improve the response. Due to the high frequency of simultaneous involvement of perineum and true pelvis the authors recommend irradiation of both regions. Palliation is the sole aim in most cases. However, curative treatment can be attempted in single perineal recurrences.