Cushing’s disease, or pituitary ACTH adenoma, is a Cushing’s syndrome caused by anterior pituitary tumors and is a rare disease with an annual incidence of 1.2-2.4 per million people. due to atypical symptoms, difficulty in diagnosis, and high requirements for endocrine testing, many hospitals are unable to diagnose and treat the disease in a timely manner. Surgery is preferred for Cushing’s disease, but postoperative outcomes vary greatly due to varying levels of physicians. For patients with postoperative recurrence or tumor residual, how to choose the treatment? 1. For patients whose postoperative review MRI enhancement can still show clear tumor and whose endocrine examination is consistent with Cushing’s disease, secondary surgery is recommended; 2. For those with negative MRI, i.e. MRI cannot show tumor, the endocrine test results should be carefully analyzed. If the HDDST is consistent with Cushing’s disease and the IPSS is also suggestive of pituitary origin, a second surgical exploration may be considered with full confidentiality of the patient. However, it should be clear that the remission rate of the second surgery is significantly lower than that of the first surgery; 3. The patient should be fully informed about the risks of the second surgery. The risk of intraoperative exploration for cerebrospinal fluid leakage is significantly increased by the fact that the anatomical structure is already disturbed at the time of reoperation and the presence of a partially vacuolated pterygoid saddle in most cases after the first surgery to remove the tumor and peritumoral pituitary. Secondary intracranial infections, including fungal infections, are very difficult to treat. If the tumor is still not seen in intraoperative exploration of some of the disease inversions, the surgical efficacy is poor; 4. For those with high risk of surgical exploration, high chance of complications, and patients who refuse secondary surgery, radiation therapy can be considered. However, radiotherapy generally reaches its peak in about 1 year and may cause hypopituitarism and radiotherapy affects visual function, etc.; 5. At present, there are no listed drugs for Cushing’s disease in China.