The optimal management of isolated local recurrence of prostate cancer following radical prostatectomy remains unknown. Salvage radiotherapy to the prostatic bed is one of management options. This article reviews the efficacy of salvage radiotherapy. The available data suggest that salvage radiotherapy offers excellent clinical local control. However, the probability of long-term disease free survival with salvage radiotherapy alone appears small as a significant proportion of patients develop distant metastases and rising prostate specific antigen (PSA) following radiotherapy. A strategy of combining systemic therapy with local salvage treatment needs to be explored for this poor prognostic group.