It is occasionally difficult to treat a locally recurrent gynecologic cancer definitively. Local recurrence (LR) is associated with such symptoms as bleeding or pain, and threatens a patient’s quality of life. The aim of this analysis is to evaluate the efficacy of interstitial brachytherapy (IBT) for LR of the gynecologic cancers. We analyzed 46 patients (pts) treated with IBT between August 2008 and March 2013. Median age was 63 years (range, 34-88 years). Tumor characteristics were as follows, primary site: cervix/corpus/others in 34/10/2 and histologic type: squamous cell carcinoma/adenocarcinoma/others in 30/14/2. Thirty three patients had previous RT history as initial treatment. Previous RT was given to 22 pts as definitive primary treatment, to 9 as pre/post-operative setting, and to 2 as RT for recurrence after surgery. Thirteen patients who had no previous RT history were received surgery as initial treatment. When IBT was performed, median tumor size was 3.6 cm (range, no detection on imaging study-8.5cm) and the main tumor location was cervix, parametrium/vagina/vaginal stump/vulva in 15/11/19/1 pts. Twelve tumors invaded to the surrounding organs, such as bladder or rectum. Thirteen pts received external beam radiation therapy and IBT. Two received LDR IBT (Cs) and 44 received HDR IBT (Ir). In cases with HDR IBT, 12 Gy/2fx/1days-42 Gy/7fx/4days to CTV was irradiated by IBT. Median total dose to CTV was 53.6 GyEQD2 (α/β ratio of 10 Gy) (range, 38.0-83.3 Gy). Median follow up period was 21.0 months (range, 3.0-59.3 months). CR was achieved in 33 pts (71.7%) and 29 pts (63.0%) obtained local control at the time of analysis. Overall survival rate (OS) at 1yr/2yr/3yr were 84.8%/49.4%/42.7%, local control rate (LC) were 84.0%/62.5%/54.1%, respectively. 2yr OS were 57.5% for pts without previous RT history and 45.6% with previous RT history (P=.25). Two-year LC were 87.5% and 51.9% (P=.01). Univariate analysis revealed no previous RT history, primary site excluding cervical cancer, tumor size (<3 cm), and the time from diagnosis of LR to IBT (<1year) were significant factors for LC (P=.01, .04, .04, and .01, respectively). In multivariate analysis, tumor size (<3 cm) was only significant factors for LC (P<.01). In the pts without LR after IBT, rectal bleeding after IBT was recognized in 8 pts (Gr1/2 in 6/2 pts), Gr3 or more rectal bleeding were not seen. Rectovaginal fistula occurred in 3 pts and 2 of them needed colostomy. Vesicovaginal fistula occurred in 5 pts, one of them received urinary diversion. Fistula was not recognized in the pts who had no previous RT history. IBT for locally recurrent gynecologic cancers with or without previous RT history was effective for local control and late adverse events were feasible.