Purpose: Surveillance following curative-intent oncological surgery aims to detect early recurrence while managing functional sequelae. For most malignancies, follow-up is guideline-based and delivered through MDT. However, in the context of radical or re-operative surgery such as pelvic exenteration (PE), robust procedure-specific surveillance guidance is lacking. This study aimed to evaluate the literature and characterise PelvEx surgeons’ perspectives on oncological and functional surveillance. Methodology: A literature search (Jan 00–Dec 24) identified studies reporting oncological and/or functional follow-up after PE. Data extracted included follow-up frequency and modality. A cross-sectional, questionnaire-based survey was disseminated via PelvEx – an international collaborative of PE specialists (Nov 24–Jul 25). Surgical demographics and experience were collected, and descriptive analyses summarised practice patterns. Results: Forty-two studies were included (39 cohort; 3 non-original). Oncological follow-up, described in 28 studies, recommended clinic visits every 3–4 months for 2–3 years, then annual review after 5 years. Frequencies of tumour markers, imaging, and endoscopies varied widely. Functional follow-up was addressed in 19 studies (often using EORTC QLQ-C30 and SF-36), but approaches were inconsistent. The survey received 176 responses from 32 countries (46% completion). Respondents were colorectal surgeons (71%) or surgical oncologist (21%), with median experience 14 years (IQR 8-20) and PE volume 15 cases/year (IQR 10-25). For surveillance, most reported outpatient review (91%), CEA (88%), CT (96%), and endoscopy (85%). Functional follow-up was less standardised, 50% of surgeons reviewed them outpatient, or 16% referred to other specialists. Conclusion: Both the literature and surgeon practice demonstrate marked heterogeneity – especially for functional follow-up – supporting development of consensus-based, MDT pathways after PE. Future studies should consider patient priorities and cost-effectiveness to guide collaborative standardisation.