Emergency operations due to sudden malignant obstruction of the left colon are associated with higher postoperative mortality and morbidity in comparison to elective operations. Opinions on the optimal surgical management are not uniform. Operations can be carried out in one, two or three phases. After admission, general condition of the patient determines which method of treatment will be performed. Analyses show better results after treatment in one phase. With the most recent approach which involves the insertion of stents in the large bowel, we eliminate the need for emergency surgery, relieve intestinal obstruction and perform elective radical surgery when the patient’s condition improves. Endoscopic stenting may represent a definitive palliative treatment instead of deriving the intestine to the skin surface in advanced disease.