Generally speaking, except for primary and a few secondary glioma patients who may be cured, most glioma patients have to face the problem of tumor recurrence, so what should we do when a new lesion is found near the original surgical area in the skull during our follow-up review? First of all, we have to identify whether the lesion is a tumor recurrence or a radiation reaction. If it is a radiological reaction, we can choose observation or conservative treatment such as hormone or bevacizumab to observe the progress of the lesion during the treatment. If recurrence is considered, we have to analyze each case according to the patient’s age, physical condition, size and location of the lesion, radiotherapy or not. If the lesion is small, patients who have not had radiotherapy can choose to have radiotherapy first and then observe the progression of the lesion. Patients who have done radiotherapy can consider changing their chemotherapy regimen, such as changing temozolomide from the standard 5/28 to a dose density regimen, or switching to irinotecan, or combining targeted drugs, etc. Patients with limited lesions can consider gamma knife or radio-wave knife and other radiotherapy treatments. Or participate in clinical trials. If the lesion is larger, we should first analyze whether it can be treated by surgery again according to the situation. The patient is in good physical condition, the lesion is located in the former location superficial, or located in the non-functional area, the surgery will not bring serious neurological dysfunction and risk, then the first choice is surgical excision, and after surgery, choose chemotherapy or radiotherapy according to the situation. This can achieve the best treatment effect. If you can operate, you should try to operate first. If the lesion is large and widespread, deep, or if surgery is risky and may bring serious neurological dysfunction or risk, then we first choose to combine chemotherapy, targeted therapy or participate in clinical trials. Radiotherapy depends on the specific situation, some patients can be treated with secondary radiotherapy, and the dose of the initial radiotherapy, the time interval between the initial radiotherapy, the site and volume of the recurrent tumor, and many other factors should be taken into consideration when re-course radiotherapy for recurrent glioma.