Colon cancer is the second leading cause of death for cancer disease, after lung cancer, with nearly 18,000 deaths per year in Italy. In spite of the progress that have taken place over the past 30 years, little improvement has been gained in this dismal outcome, and the 5-year survival remains around 50%. Over one half of the patients will suffer from recurrence after a potentially curative resection. A major challenge lies in better detection of recurrences in order to diagnose those patients still amenable to curative resection. Locoregional recurrence is of particular interest and its frequency, diagnostic limitations and surgical treatment are herein discussed.