Abstract： Objective To discuss causes for recurrent pectus excavatum and summarize our experiences in secondary pectus excavatum repairs.Methods Total 113 cases(3 of them were repaired twice) underwent procedures from January 1996 to November 2010 in our center and 110 of them were followed up.The original procedures included Ravitch procedures in 13,osteotomy combined external fixation in 5,osteotomy combined internal fixation in 59,and suspension technique in 4,as well as NUSS procedure in 32.The secondary procedures include Ravitch procedures in 2,osteotomy combined internal fixation in 15,NUSS procedures in 71,and NUSS combined osteotomy in 25.Results All patients were done successfully and 3 cases recurred after osteotomy combined internal fixation.They underwent secondary operation (NUSS combined osteotomy).The operation time ranged from 30 to 420 minutes.Conclusions The internal causes of recurrent pectus excavatum include Marfan syndrome,neurofibromatosis which may lead the disorder of sclerotic and over-growth.The external causes include unsuitable technique,uncorrected procedure,poor pedestal strength and less time to support to sternum.NUSS procedure、NUSS combined osteotomy procedure are the effect techniques to repair recurrent pectus excavatum.However,lone term of efficacy evaluation is still needed.