Recurrence of rectal cancer accounts for about 60% of colorectal cancer, and the 5-year survival rate after radical surgery is 50% to 80%. The main causes of treatment failure are local recurrence and distant metastasis. Local recurrence may be a major factor in recent death after rectal cancer surgery, and about 80% of patients die from local recurrence without distant metastasis. The literature reports that the local recurrence rate of rectal cancer ranges from 12.7% to 31%, which shows that the treatment of local recurrence of radical surgery for rectal cancer has important clinical significance in improving the survival rate of rectal cancer. Local recurrence is common in anastomosis, pelvis, perineum and abdominal wall incision, and may involve lymph nodes, peritoneum and adjacent organs. Local recurrences mostly invade the soft tissues and adjacent organs or structures in the pelvis. It is more difficult to treat the complex surrounding structures. Rectal cancer recurrence can be treated by surgery, chemotherapy and radiotherapy. In recent years, CT-guided radioactive particle implantation has made great progress in the treatment of postoperative recurrence of rectal cancer. The basic method is to calculate the dose distribution of radioactive particles in the recurrent tumor area and its surrounding space according to the size, morphology, relationship of surrounding organs and tissues as shown in the patient’s imaging data, and to draw the isodose curve and particle distribution map by applying the computerized treatment planning system in combination with radioactive particle activity. The prescribed dose is given, and percutaneous puncture particle implantation is realized under CT guidance. The CT-guided percutaneous puncture radioactive particle implantation can directly and accurately irradiate the local recurrent tumor site, which can exert the maximum tumor-specific effect and cause little damage to normal tissues, even if the patient has had external radiation therapy before. To sum up, the specific method to be used for recurrence of rectal cancer after surgery needs to be based on the patient’s condition, and the purpose of treatment should always be considered around improving the quality and prolonging the life time of patients.