Abstract: Recurrence of malignant tumors after surgery and radiotherapy and chemotherapy is the main cause of death in patients. There is a basis for the prevention and treatment of malignant tumor recurrence with traditional Chinese medicine, but its clinical diagnosis and treatment still lacks the guidance of the core pathogenesis theory. This paper reviews the pathogenesis of malignant tumor recurrence from ancient times to the present. Based on the theory of cancer toxin pathogenesis and combined with the progress of modern medical research, the paper summarizes the core pathogenesis of malignant tumor recurrence, including "deficiency of healthy qi, recurrence of residual toxin" and "accumulation of phlegm and stasis, recurrence of cancer toxin". It proposes the prevention and treatment strategies of strengthening the healthy qi and consolidating the foundation, focusing on the coordination of the spleen and kidney, restraining the evil and toxin; resolving phlegm and removing stasis, focusing on promoting the expulsion of evil and clearing the remaining evil; protecting against cancer and detoxification, focusing on distinguishing the location and nature of disease, and classifying the use of herbals.