Colonoscopy has become the most commonly used method to the diagnosis and treatment of colorectal diseases at present.Colonoscopic perforation is considered the most serious complication with high mortality, especially in the patients with certain risk factors and iatrogenic factors, despite of its low incidence.According to the clinical features in the period of perioperative colonoscopy, early detection of colonoscopic perforation is a prerequisite for successful treatment and the key to lower mortality.So far in the treatment,some methods can be selected, including conservative treatment, open surgery, laparoscopic surgery and endoscopy folders, etc.Clinical judgement and analysis of disease should be specific and accurate, but not to be generalized.Doctors should adopt reasonable and effective treatment options according to clinical performance, the size of perforation,intestinal readiness, time of diagnosis, colon primary lesion and so on.