Introduction: Globally, over 2 million colorectal cancer cases were diagnosed. It is the second most common cause of cancer fatalities, causing 1 million deaths annually. The current study aimed to compare surgery and chemoradiotherapy treatment outcomes in colorectal cancer recurrence. Method: The current study was conducted using a randomized clinical trial design. The study was carried out at Hayatabad Medical Complex, Peshawar. A total of 74 patients previously treated for colorectal cancer, were selected. The patients who showed recurrence, based on radiology results, were selected for the current study. Survival from the commencement of chemoradiotherapy/surgery to death from any cause or censoring at the final follow-up was defined as overall survival (OS). OS were calculated using the Kaplan–Meier technique and compared with the log-rank test. All analyses were conducted using SPSS v25 and Jamovi. Result: A total of 21 patient included in the final analysis. The mean age in the surgery group was quite higher than the chemoradiotherapy group (p = 0.31). The male to female ratio in each group was 12/4, 8/3 respectively. The timer size was quite higher than the chemoradiotherapy group (p = 0.20). Two patients were died in the chemoradiotherapy group while one patient was died in surgery group. The survival rate of the surgery was quite good as compared to the chemoradiotherapy group. In the chemoradiotherapy group the patients survived up to 30 months, however, the patient treats with surgery showed the longest survival. Conclusion: The current study compared the surgery and Chemo-radio therapy in locally recurrent colorectal cancer. Two patients in the chemoradiotherapy group and one in the surgery group was died. Compared to those who had chemoradiation, surgical patients had a much higher chance of survival. In the chemoradiotherapy group, patients lived up to 30 months; nevertheless, the surgical group had the longest survival rate

Keywords : Colorectal Cancer, Recurrence, Chemoradiotherapy, Surgery.