Forty-eight patients with recurrent cervical cancer of the vaginal stump following hysterectomy for cervical cancer, were treated with high dose rate intracavitary brachytherapy with or without external irradiation. The intervals between primary surgery and vaginal recurrences varied widely from 3 months to 36 years. Patients were classified into two groups, either with or without palpable tumor of the vaginal stump. Tumor size was determined by bimanual rectovaginal examination at the time of recurrence. Survival rates were 8% for the group with palpable tumors and 80% for those without, respectively. The survival rate of patients who did not have palpable masses and were treated with brachytherapy alone was not improved by combination with external irradiation. The time interval from the primary hysterectomy to the recurrence did not influence survival. These results suggest that the only significant prognostic factor for recurrent cervical cancer after hysterectomy is tumor size. The relationship between recurrent cervical cancer of the vaginal stump and second primary vaginal cancer is also discussed.