Objective To explore the principles and methods of surgcal treatment for acute neoplastic colorectal obstruction.Methods The clinical data of 103 patients diagnosed as acute neoplastic colorectal obstruction were analyzed retrospectively.Results In this group,80 cases underwent emergency surgical treatment,(among) which,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(operations) were performed in 10 cases of rectal cancer.23 cases received non-emergency surgery.(Anastomotic) fistula 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.Conclusions The 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(resection) should be performed if possible.