High-grade gliomas (WHO grade III-IV) are the most common malignant primary brain tumors in adults. Treatment options for new cases include maximum safe resection and subsequent concurrent radiotherapy, with a current median survival of only 12-15 months. Patients will eventually experience tumor recurrence after treatment, but treatment after recurrence lacks accepted criteria, and the choice of reoperation is controversial. 31 meaningful independent studies were included in this study, and the study data were divided into early (1980-2002) and late (2002-present) because of the administration of temozolomide concurrent radiotherapy regimens since 2002. The retrospective study was more cautiously enrolled cases under 50 years of age, with an interoperative interval of ≥9 months, a KPS score of ≥90, and total tumor resection at the time of reoperation. Earlier clinical studies have shown that age, Karlsberg functional status score (KPS), and the presence of an interoperative interval of more than 6 months are relevant factors in assessing the benefit of reoperation. Approximately 5% to 50% of patients who underwent reoperation had improved postoperative KPS scores. A later clinical study suggested that patients who underwent reoperation had an overall median survival that was nearly 10 months longer than those who did not undergo reoperation. The authors noted that indications for reoperation included new focal neurological deficits, tumor occupancy resulting in neurological deficits, increased intracranial pressure, progressive headache, changes in consciousness, frequent or persistent epilepsy, and imaging studies confirming tumor enlargement. The prognosis was better for those with a pathological diagnosis of radionecrosis at reoperation. In addition, age <50 years, KPS ≥70 score, longer interoperative interval, smaller tumor size, and extent of tumor re-excision were associated with improved survival. The median survival at reoperation has been reported to be 11 months for total resection, 9 months for subtotal resection, and 5 months for partial resection. High-grade gliomas are most often seen in people over 60 years of age, and studies in this population suggest that reoperation, extent of tumor resection, and radiation therapy, remain independent factors that confer benefit. Therefore, it is recommended that reoperation should be considered in patients of all ages with recurrence. And the review did not find significant differences in complications of reoperation versus first surgery. I am often asked in the clinic and online what to do for recurrent glioma. Should I operate? Or radiation therapy and continue temozolomide chemotherapy? Or wait? I remember a few months ago, a woman in her 30s, 3 years after glioma surgery, had a grade 2 glioma as a result of her first surgery, and now the tumor is growing again. Is it the effect of radiotherapy or the tumor has invaded to the opposite side again? I don't know. He came to the hospital and consulted with radiotherapy specialists and glioma specialists, but still could not get a satisfactory answer. She came to me, and I thought that the recurrent side of the glioma must be operated, and the patient was young and had no complications. She underwent surgery with good results, but the edema side was not treated. The pathology this time was interstitial mixed with glioma and postoperative chemotherapy. In the future, it is unknown. But with respect to the above literature, the meaningful answer is that we made the right choice. Glioma is still a difficult problem that plagues neurosurgery and surgery is the only option for prognosis for recurrence, 2 times, 3 times ...... still makes sense.