Minimally invasive surgery has gain in popularity showing low morbidity with good oncological outcomes. This is a case report of resection of mesorectal and para aortic lymph node recurrence of primary ovarian cancer performed by retroperitoneal laparoscopy and trans anal minimally invasive surgery (TAMIS) approach. A 66-year-old female, diagnosed with ovarian adenocarcinoma stage IIa, on December 2014 underwent cytoreductive surgery achieving a R0 resection (complete hysterectomywith bilateral ovariectomy, pelvic peritenectomy with standard lymphadenectomyand supramesocolic omentectomy) followed by adjuvant treatment. On November 2017 a CT scan revealed a lymph node recurrence located in the left abdominal para aortic side (2.5 cm) and mesorectal space (2.8 cm) at 10 cm from anal verge. After multidisciplinary session, both nodes underwent surgical resection. The para aortic node was resected through retroperitoneal laparoscopy and the mesorectal node resected through TAMIS approach. The post-operative curse was uneventful and the patient was discharged 5 days after the surgery. Histopathological examination of the 2 nodes revealed undifferentiated serosal ovarian adenocarcinoma.