Abstract: The papillary thyroid cancer (PTC) patients have general good prognosis, but the relapse occurred in 20%-30% patients after initial treatment, which resulted in poor prognosis and treatment difficulty. ¹³¹I can act as a part of postoperative adjuvant therapy for the initial standard treatment of middle- or high-risk PTC patients, and it still could play important roles in the diagnosis and treatment of recurrent PTC. ¹³¹I can contribute to early detection, accurate location and iodine uptake evaluation of recurrence foci and is helpful for the subsequent treatment scheme. ¹³¹I can serve as a part of radical treatment for small recurrent foci, postoperative adjuvant treatment for resectable lesions and palliative treatment for unresectable ones. This paper reviews the value of ¹³¹I treatment as the adjuvant therapy followed by reoperation in recurrent PTC.