The oncological adequacy of a surgical operation is important in providing emergency surgical care to patients with complicated colorectal cancer (CRC). Surgical treatment for colon cancer has undergone spectacular changes over the past two decades; however, in practice there is no single oncological approach to treating this disease at general surgery hospitals. Objective — to study 5-year overall and recurrence-free survival rates in patients with complicated CRC, who underwent emergency resections. Subject and methods. Treatment outcomes were analyzed in 1098 patients with complicated CRC, who had undergone emergency surgery. A total of 210 patients who had died within 30 days after surgery were excluded from the study. Five-year overall and recurrence-free survival rates were analyzed in 888 patients with resectable complicated colon cancer (intestinal obstruction, perforation, bleeding, and associated complications), who had been operated on urgently in Smolensk healthcare facilities of different specializations in the period 2001 to 2013. The patients were divided into 2 groups: 1) those who had undergone emergency resections at specialized hospitals; 2) those who had at general surgery ones. Results. Group comparisons by the resection status revealed a preponderance of tumor growth along the resection lines during emergency resections in the patients operated on at general surgery hospitals (p<0.0001). According to the number of the lymph nodes examined, the differences between the groups were found to be statistically significant (p<0.0001); the average number of the lymph nodes examined was 12±3 at the specialized hospitals and 5±2 at the general surgery ones. The compared groups of patients with stages II-IIIC CRC showed statistically significant differences in recurrence-free and overall survival rates that were significantly higher in the patients operated on at the specialized hospitals (p=0.00001). Conclusion. Interventions at general surgery hospitals should be carried out to the minimum extent aimed at eliminating emergency complications and qualified oncological assistance should be subsequently provided by coloproctologists or oncologists at a specialized department.