Glioma is a primary malignant tumor of the central nervous system and is treated mainly by surgery, often with radiotherapy and chemotherapy as adjuvant treatment. Nevertheless, many glioma patients still experience recurrence after surgery, which seriously affects patients’ survival quality and prognosis. Therefore, how to treat recurrence of glioma after surgery has become a concern for many neurosurgeons. According to the latest research results, a comprehensive treatment based on surgery combined with radiotherapy and chemotherapy and molecular biology is still recommended as the first choice. The prognosis of postoperative recurrent glioma patients is related to age, tumor size, growth location, pathological grading and extent of surgical resection. First of all, the diagnosis of recurrent glioma has to be clarified. Many patients often find that there are often suspicious foci of varying degrees of enhancement in the operated area during postoperative cranial MRI review, which is suspected of tumor recurrence. The imaging manifestations and clinical symptoms of glioma recurrence and radiation injury are similar, but the treatments are different. For radiation injury, conservative treatments such as improvement of symptoms are mostly used, while glioma recurrence requires radiotherapy or secondary surgery. The following tests are often used to differentiate glioma recurrence from radiation damage: diffusion-weighted imaging (DWI), magnetic resonance spectroscopy (MRS), magnetic resonance perfusion imaging (PWI), and positron emission tomography (PET). Which patients with recurrence are suitable for surgery? Before surgery, we need to have a thorough understanding and evaluation of the patient’s basic condition, imaging results and previous pathology. For patients with recurrent glioma, preoperative KPS score > 60, especially for patients with lesions located in non-functional areas of the brain, surgery should be advocated even if there are multiple recurrences. However, the management of patients with a recent history of radiotherapy and found to have recurrence of glioma after surgery can be somewhat special. Radiotherapy is used to induce pre-programmed necrosis of tumor cells as well as to destroy tumor tissue by applying direct killing of tumor cells by radiation until they die. In recurrent gliomas, the intracranial occupancy effect is obvious. Radioactive cerebral edema caused by radiotherapy, etc. will further aggravate cerebral edema and induce serious complications such as brain herniation. Therefore, radiotherapy should not be administered before surgery. What factors can affect the prognosis of patients with recurrent glioma? The main factors affecting the prognosis of recurrent glioma are the pathological grade of the glioma, the extent of surgical resection of the primary lesion, the sensitivity of the lesion to radiotherapy, and the patient’s functional status, which can be used as a reference to determine the prognosis of recurrent glioma reoperation. The following factors suggest a poor prognosis including: 1. maximum tumor diameter ≥ 6 cm; 2. astrocytoma tissue subtype; 3. age ≥ 60 years; 4. tumor crossing the midline; 5. presence of neurological deficits before surgery (excluding simple seizures) and dividing patients with low-grade glioma into low-risk and high-risk groups: ≤ 2 factors for low-risk group, ≥ 3 factors for high-risk group, and low-grade for low-risk group The median survival time for glioma was 7.72 years in the low-risk group and 3.2 years in the high-risk group. in 2008, scholars chang et al. proposed the UCSF scoring system to classify patients with low-grade glioma into low-risk (0-1 score), intermediate risk (2 score), high-risk ( 3 to 4 points), with 5-year progression-free survival rates of 76%, 49%, and 18%, respectively, and 5-year overall survival rates of 97%, 81%, and 56%, respectively. It has been shown that for recurrent glioma reoperation, patients aged ≤60 years have better survival than patients >60 years, and patients with preoperative KPS scores >70 years have better survival than patients with scores ≤70 years. In conclusion, how to increase the interval of tumor recurrence, improve the quality of survival and prolong the survival of patients with recurrent glioma is the direction that neurosurgeons and medical colleagues are striving for. At present, the principle of recurrent glioma treatment is still a comprehensive treatment mainly based on surgery, supplemented by adjuvant radiotherapy and chemotherapy. The grasp of the indications and principles of surgery, surgical modalities, techniques and the application of surgical adjuvant techniques directly affect the resection of tumors and the occurrence of complications.