Recurrence after surgery for rectal prolapse occurs between 5% and 50%,varying with the technique used,and the surgeons application of the technique.Factors contributing to the recurrence include insufficient resection and/or fixation at the time of the first surgery,incomplete preoperative evaluation of pelvic floor pathology,or a new pelvic floor abnormality,mimicking or causing rectal prolapse.Whether or not the original evaluation of the pelvic structures was complete,it generally needs to be repeated prior to a decision about the best approach to the patient with recurrent rectal prolapse.Appropriate contemporary evaluation and decision-making strategies will be presented.