The study summarize the results of diagnostics and treatment of 536 patients aged 37-97 years with colon cancer stage II-IV, complicated by bowel obstruction. Patients with subcompensated and decompensated bowel obstruction prevailed. The dependence of the clinical picture from the tumor localization and the severity of the obstruction were identified. The authors pose that the decision about the median laparotomy needs the preoperative diagnosis of the obturative obstruction without verification of its causes. Decision about the delayed radical operation and minimizing the treatment to colon decompression should be based on additional diagnostic data (X-ray, irrigoscopy and colonoscopy). Surgical interventions with the median laparotomy showed the mortality rate of 30.7% and morbidity of 57.5%. The miniinvasive decompression of the colon reduces these rates to 1.8 and 7.1%, respectively.