Abstract: Colorectal cancer is a common malignant tumor of the digestive system. The incidence of colorectal cancer with obstruction is up to 20%, and 70% of such cases occur in the left colon. There is still no consensus on the treatment of obstructive left colon cancer. In patients with malignant obstruction, emergency or elective surgery is usually performed after implantation of autologous expandable metal stents. Tumor removal as an emergency procedure has high mortality and complication rates. Metal stent implantation greatly reduces the incidence of dangerous complications, but the long-term prognosis is not significantly improved. The surgical options available are staged surgery and one-stage intestinal resection and anastomosis. Staged surgery is expensive, while one-stage intestinal resection and anastomosis has a high risk of leakage. Choosing the most beneficial treatment for patients tests the clinical ability of surgeons, and more multi-center clinical research is needed. This article will review the current status and controversies in the treatment of obstructive left colon cancer.