Background: Subtotal colectomy  with ileosigmoid  or ileorectal anastomosis is one of the standard procedures for obstructed tumors of the left colon. Traditionally, left sided acute bowel obstruction is treated by a staged procedure because immediate resection and anastomosis in a massive distended and unprepared colon carries a high complication rate. One of the arguments for subtotal colectomy is that this procedure will remove synchronous proximal neoplasms and reduce the risk of subsequent metachronous  tumor. The purpose of this study was to evaluate the procedure of subtotal colectomy in the management  of acute obstructed  carcinoma of the left colon as a single stage operation. Methods: From January 2009 to December 2011, this study included 60 consecutive patients who underwent emergency operations for obstructing primary  left colorectal cancers  with ileosigmoid or ileorectal anastomosis according to tumor position. Results: The site of left colon obstruction was the rectosigmoid in 24 patients (40%), sigmoid colon in 28 patients (46.6%), descending colon in 3 patients (5%), and the splenic flexure in 5 patients (8.3%). The histopathology was Dukes B2 in 15 patients (25%), Dukes C in 25 patients (41.66%), Dukes Din 20 patients  (33.33%). Fifty six patients  (93.33%)  had an obstructing cancer. Four patients (6.66%) had synchronous tumors (caecum in two patients; hepatic flexure in one patient and transverse colon in one patient). Conclusion: This study has shown that patients who present with left sided colonic obstruction may be safely  treated  by primary  resection and  anastomosis with satisfactory outcomes.