Malignant colonic obstruction (MCO) is a pathological condition in which there is a complete or partial cessation of the passage through the intestinal tube. The emergency nature of the MCO leads to the need for decompression of proximal intestinal in the shortest possible time, especially in patients with severe concomitant diseases. The purpose of the study is to compare the effectiveness of bowel preparation for surgical treatment in patients with colorectal cancer complicated by MCO with the use of endoscopic stenting and the unloading stoma formation. This work is a prospective, single-center, randomized study. All consecutively admitted to the Clinic of Colorectal and Minimally Invasive Surgery, The Second University Clinic patients with colorectal cancer complicated by MCO were included. All patients, included in the study, were randomized into two groups: group I — patients who underwent endoscopic placement of a self-expanding metal stent to resolve MCO, group II — unloading intestinal stoma formation. The proposed study design allows us to obtain data of the efficacy and safety of the compared methods for the resolution of MCO. The use of a randomized approach improves the level of evidence. Wider acceptance, in turn, will allow designing a multicenter randomized trial to provide a large sample of patients and a definitive answer to the question of the role of endoscopic stenting as a clinical recommendation for the resolution of MCO in colorectal cancer. Despite all efforts aimed at early diagnosis of colorectal cancer, tumors usually remain undiagnosed on the early stages due to their asymptomatic form. Frequently, patients find out about their diagnosis when treatment of CRC complications, such as bleeding or MCO, begins. It has been shown that in order to improve oncological and functional results, it is necessary to resolve MCO firstly. Classically, surgeons performs stoma formation for this purpose, however the use of endoscopic stents is still a matter of debate. This is also due to the lack of a sufficient number of studies with a high level of evidence.