Objective To compare the therapeutic result of endoscopic po lypectomy with colectomy for polypoid malignant colorectal tumor. Methods A tot al of 61 cases of polypoid malignant colorectal tumor including thirty- nine pa tients treated by endoscopic polypectomy and surveillance,twenty- two patients treated by colectomy.Follow- up ranged from 28 to 168(mean 64) months. Results During the follow- up period,one patient died relating to this disease,two rec urred at the original site,and one metastasized to the liver.The distribution of the adverse outcome had no significant statistical difference between the group of endoscopic polypectomy and colectomy;significant difference existed between the sessile and pedunculated malignant polyps (P=0.006),as well as between favou rable(carcinoma invading the muscularis mucosa or above,limited to the head of t he pedunculated polyp,polypectomy margin negative,and well and moderately differ entiated)and unfavourable(without those criteria) histologic characteristics(P=0 .002).Conclusion The polypoid malignant colorectal tumors with favourable his tologic characteristics could be treated by endoscopic polypectomy alone,tumors with unfavourable histologic characteristics should be treated by colectomy.