Abstract: The treatment of locally recurrent rectal cancer (LRRC) is multidisciplinary, including surgery, external beam radiotherapy, intraoperative radiotherapy, radioactive seed implantation, hyperthermia therapy, radiofrequency ablation, etc. Nevertheless, the predominant treatments are surgery and radiotherapy. Complete resection (R0 resection) is an independent prognostic factor. With the advent of intensity modulated radiation therapy (IMRT) and stereotactic body radiotherapy (SBRT), the efficacy of re-irradiation for patients who have previously received radiotherapy is confirmed, and the side effects are acceptable. Moreover, with the development of more treatment modalities, the survival rate and local control rate of patients are increasing, and the quality of life is improved. In conclusion, the treatment of LRRC is comprehensive and requires the participation of multidisciplinary physicians. However, proper and effective treatment needs more research evidence. This review summarized the latest progress in the multidisciplinary treatment of LRRC and the unresolved problems.