ObjectiveTo explore the principles and methods of surgcal treatment for acute neoplastic colorectal obstruction.MethodsThe clinical data of 103 patients diagnosed as acute neoplastic colorectal obstruction were analyzed retrospectively.ResultsIn this group, 80 cases underwent emergency surgical treatment, amongwhich, 25 cases of carcinoma of right colon underwent primary resection and anastomosis; in 45 cases of carcinoma of left colon, primary resection and anastomosis was performed in 37 cases; and emergent operationswere performed in 10 cases of rectal cancer. 23 cases received nonemergency surgery. Anastomoticfistula occurred in 3 patients, pulmonary infection in 2 patients, pelvic cavity infection in 1 patient, 1 patient died and the rest recovered well and were discharged.ConclusionsThe initial treatment for acute neoplastic colorectal obstruction should be nonsurgcal treatment for 1~3d to make nonemergency surgical treatment more possible. If indications are properly selected, primary tumor resection and anastomosis is safe. For patients with severe contamination of abdominal cavity and bowel perforation, primary tumor resectionshould be performed if possible.