Of 1,033 patients with colorectal carcinoma, 238 (23%) presented with obstruction. The majority of tumours (74%) were potentially curable (Dukes B/C) at presentation. Tumours situated at the splenic flexure, transverse or descending colon were most likely to obstruct. Perioperative mortality was high following either primary resection (31%) or fashioning of a defunctioning stoma alone (25%) but was twice as high (40%) in patients over 70 than those under 70 (20%). Cardiorespiratory complications accounted for 55% of this mortality, while fatal technical complications occurred in 19%. Sixty seven patients (28%) had two operations, 51 patients (21%) had three operations.