Objective:To explore the causes， clinical characteristics and treatment of acute perforation of colon. Methods:The clinical data of 22 cases of acute colonic perforation from treated Feb 2007 to Feb 2010 Were retrospectively analysed. Results:The etiology of perforation was cancer in 54.5%(12/22)， trauma in 27.3%(6/22)，fecal impaction in 9.1%(2/22)， diverticulitis in 4.5%(1/22)，and intussusception in 4.5%(1/22).The location of perforation: cecum accounted for 31.8%(7/22)， transverse colon for 18.2%(4/22)， descending colons for 9.1%(2/22)，and sigmoid colon for 40.9%(9/22).All cases underwent emergency surgery，with one-stage operation in 7cases(31.8%), staged operation in 11 cases(50.0%), and permenent colostomy in 4(18.2%). After surgery， 6 cases had pulmonary infection， of which 2 cases with pleural effusion were improved by paracentesis， 2 cases with ARDS were improved by mechanical ventilation,and 2 cases with subphrenic abscess were improved by ultrasound-guided drainage.There were 10 cases of wound infection， of which 7 cases were cured by dressing change and 3 cases with abdominal incision dehiscence underwent resuture. One case with enterocutaneous fistula was treated by colostomy.Of the 20 cases，18 cases(81.8%) were cured， 2cases(9.1%)died from septic shock and MOF，and 2 cases(9.1%) were discharged against-advice. Conclusions:Improving the understanding of this disorder，early diagnosis， prompt and proper surgical procedure are the keys to improve the treatment effect of colonic perforation.