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The majority of CRC cases arise through two well\u2010established pathways: the conventional adenoma\u2013carcinoma sequence and the serrated neoplasia pathway. Colonoscopic polypectomy significantly reduces the incidence of CRC, yet postoperative recurrence rates remain substantial, underscoring the critical role of post\u2010polypectomy colonoscopic surveillance (PPCS). Recent updates to PPCS guidelines by major gastroenterological societies\u2014including the US Multisociety Task Force (USMSTF), European Society of Gastrointestinal Endoscopy (ESGE), British Society of Gastroenterology\/Association of Coloproctology of Great Britain and Ireland\/Public Health England (BSG\/ACPGBI\/PHE), and the Asia\u2010Pacific Task Force\u2014reflect evolving strategies for risk stratification and surveillance intervals. While all guidelines prioritize colonoscopy resources for high\u2010risk populations and reduce burden for low\u2010risk individuals, significant variations persist in definitions of high\u2010risk adenomas (HRA), recommendations for surveillance intervals, and management of specific histological subtypes such as villous architecture. This review comprehensively compares these updated guidelines, highlighting consensus and discordance in clinical recommendations. Furthermore, it synthesizes evidence on multifactorial recurrence risks, encompassing baseline adenoma characteristics, patient\u2010specific factors, and the quality of endoscopic procedures. Regarding the association with the same risk factor, traditional adenomas and serrated polyps may demonstrate heterogeneity. Understanding these elements is essential for optimizing personalized surveillance strategies and reducing recurrent adenoma burden. 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