Objective: Phyllodes tumor (PT) is a rare entity accounting for 1% of breast neoplasms with a high propensity of recurrence. This study aimed to identifyfactors that are predictive of early recurrence in patients with PT.Materials and Methods: This study reviewed clinical data of patients with PT (n=57) treated at our tertiary care referral center in South India betweenFebruary 2010 and December 2019. The Pearson χ2 test was used to investigate the relationship between patient’s clinical features and tumor histotypes.Survival curves were obtained using the Kaplan-Meier method based on the log-rank test. Multivariate Cox regression analyses were performed to identifypredictors of early recurrence or local recurrence-free-interval (LRFI).Results: The mean age was 38.3 [standard deviation (SD)=13.6] years, and the mean follow-up was 18 (SD=13.5) months. The median tumor size was 5cm (interquartile range 3 and range: 3–22 cm). Moreover, 64.9% (n=37) of the tumors were benign, 21.1% (n=12) were borderline, and 14% (n=8) weremalignant. Of the 57 patients, 17 (29.8%) developed local recurrence and one developed distant metastasis. Of the 17 patients, three were unwilling toundergo completion surgery. The median LRFI was 20 (range: 7–60) months. Multivariate cox regression analyses showed that mitotic rate >10/high powerfield [hazard ratio (HR) 0.147; p=0.04], stromal overgrowth (HR: 4.904; p=0.05), margin status (HR: 0.037; p<0.001), and preoperative neutrophil-tolymphocyteratio [(NLR), HR: 4.891; p=0.04)] were significant predictors of LRFI.Conclusion: A high mitotic rate, positive margin, stromal overgrowth, and NLR >3.5 were associated with early recurrence. These attributes mandatestringent follow-up, especially in a resource-limited setting.