Purpose Wide excision and subsequent reconstruction of the defect are crucial pillars in the treatment of soft tissue sarcoma (STS); however, those procedures carry a relatively high risk of postoperative complications, which could raise oncologic concerns. The present study evaluated the association of postoperative complications after resection and immediate reconstruction with STS recurrence. Methods We reviewed patients with primary STS who underwent wide resection and immediate reconstruction between 2011 and 2019. Patients were categorized into three groups based on their postoperative inflammatory complication status: no complications, noninflammatory complications, and inflammatory complications. Inflammatory complications were defined as those involving a sustained elevation of inflammatory markers in laboratory tests after postoperative 2 weeks. The cumulative incidence of oncologic events and their respective hazard ratios (HRs) were evaluated using multivariable Cox regression analyses. Results In total, 94 patients with a median follow-up of 54.8 months were analyzed, including 17 with inflammatory complications, 17 with noninflammatory complications, and 60 with no complications. The three groups showed similar baseline characteristics except for older age and a lower rate of FNCLCC (Fédération Nationale des Centres de Lutte Contre Le Cancer) grade 3 in the inflammatory complications group. The inflammatory complications group showed significantly worse disease-free survival than the no complications group. This difference remained significant after adjustment for other variables in multivariate analyses (HR, 3.485; p=0.019). The development of noninflammatory complications was not associated with oncologic outcomes. Conclusion Our findings suggest that the development of inflammatory complications following wide excision and immediate reconstruction may be associated with the recurrence of STS.