Chronic radiation enteropathy(CRE) represents a latent intestinal injury resulting from abdominal-pelvic radiotherapy. Severe complications like refractory bleeding, intestinal obstruction, perforation and fistula may occur during CRE progression. Surgical treatment is the most effective way to handle these complications. Since radiotherapy has become an important and common way to relieve or even cure many malignant tumors, the incidence of severe complications of CRE is likely to rise. Thus the value of surgical treatment in managing severe complications of CRE should gain more attention. Through the literature review combined with our clinical experience, this paper analyzes the preoperative management and surgical treatment of five long-term complications of CRE, including obstruction, enteric fistula, rectovaginal fistula, perforation and bleeding. Also we propose that when managing patients with severe complications of CRE, clinicians should carefully master the surgical indications, consummate perioperative management, design personal surgical plan according to patient's condition and make improving the quality of life of patients the ultimate purpose of surgical treatment for CRE while assuring its safety.