Early detection and accurate characterization of the extent of recurrent disease are important in identifying patients who might be candidates for local resection, pelvic exenteration, or radiotherapy. CT and MR imaging can demonstrate the site and extent of recurrence after surgery. CT is widely available, but the superior soft-tissue contrast of MR imaging allows for better assessment of the local extent of recurrent tumor. For the evaluation of widespread recurrence, CT is preferred. CT and MR imaging have limitations in assessing the response of tumors to therapy and in differentiating residual or recurrent disease from post-treatment changes due to overlap of morphological appearances. Benign conditions such as edema, inflammation, and necrosis can mimic residual tumor, complicating the assessment. This distinction is crucial for selecting patients who may benefit from further salvage treatment options. Functional imaging using dynamic multiphase contrast-enhanced MR imaging and diffusion-weighted MR imaging help overcome these limitations. In detecting recurrent lesions and evaluating treatment responses, FDG-PET, used in conjunction with anatomic information from CT or MR imaging, showed better diagnostic ability than conventional imaging and tumor markers. FDG-PET also can be useful in women who present with elevated markers but negative conventional imaging. Imaging has become an important adjunct to the assessment of uterine malignancy. They can be used to recommend suitable candidates for exenteration, additional radiation therapy, or chemotherapy.