Objective: To compare the efficacy of laparoscopic versus open surgery in the treatment of locally recurrent rectal cancer. Methods: The clinical data of 38 patients undergoing laparoscopic surgery and 70 patients undergoing open surgery after local recurrence of rectal cancer were retrospectively analyzed and compared. Results: There were no statistical differences in age, sex and clinical stage between the two groups (all P＞0.05) before operation. The intraoperative blood loss, postoperative analgesic dosage and rate of wound infection of the laparoscopic surgery group were significantly lower than those of the open surgery group (all P＜0.05). The overall incidence rate of postoperative complications of the laparoscopic group and the open surgery group was 23.7% and 32.9%, respectively, and this was significantly different (P＜0.05). Conclusions: Laparoscopic surgery for patients with locally recurrent rectal cancer is safe and effective, and is less invasive and has a faster recovery than open surgical procedures.