Aim. To improve the outcomes in patients with colon cancer complicated by acute obstruction via development of combined and complex treatment strategies. Material and methods. We observed 442 patients with colon cancer complicated with acute obstruction. Original classification and diagnostic algorithm were applied. Results. Time of preoperative opening-up, volume and type of surgery were defined using obtained data. Also we are able to perform delayed radical surgery after correction of metabolic disorders and comorbidities, to create the conditions for combined and complex methods of treatment, to decrease the incidence of postoperative complications and mortality rate. Conclusion. Three-stage surgery with shortened time between interventions decreases the incidence of anastomosis failure, allows to refuse Hartmann’s procedure and to avoid severe reconstructive surgical stage without prolongation of rehabilitation period.