Background: Post-operative follow-up protocols for renal cell carcinoma (RCC) are based on outcomes of the clear cell subtype and often rely on variables not applicable to chromophobe RCC (chRCC), such as Fuhrman nuclear grading. We aimed to evaluate predictors of recurrence to guide follow-up regimes in the context of chRCC. Methods: Combined retrospective analysis of non-metastatic surgical cases with a final diagnosis of chRCC from an institutional database at a UK tertiary high-volume centre (June/2013 to March/2019) and from the international collaborative database RECUR (12 institutes across 8 European countries; 2006 to 2011). TNM risk group, tumour size, histopathological features, cancer specific survival (CSS) and recurrence free survival (RFS) were analysed. Kaplan Meier plots and Cox regression analysis were performed to determine factors associated with recurrence (local or distant). Results: 295 cases were identified (57.3% male, median age 60). After a median follow up of 58 months, 17 (5.8%) recurrences were observed, the majority of which were distant recurrences (n = 13). CSS was 96.3%. Tumours staged ≥pT2b (HR 13.7; 95%CI 3 to 63.1; p = 0.001), with coagulative necrosis (HR 3.9; 95%CI 1.3 to 11.1; p = 0.012) and sarcomatoid differentiation (HR 33; 95%CI 8.1 to 134.6.1; p = 0.000) were more likely to recur during follow-up. Only two cases of pT1a lesions had local recurrence, both after a positive surgical margin. All patients with early recurrences ( < 18 months after surgery; n = 6) had tumours staged ≥pT2b with coagulative necrosis; sarcomatoid differentiation was also present in 3 cases. Conclusions: Recurrence of surgically resected chRCC is not common. For patients with pT1 lesions, negative margins, no coagulative necrosis or sarcomatoid features, prognosis is excellent. Follow up can be curtailed to avoid excess radiation exposure and patient anxiety.