Background: This study aimed to compare the outcomes of patients, who suffered from obstructing left-sided colorectal cancer, treated with self-expanding metallic stent (SEMS) as a bridge to surgery with those who underwent emergency operation. Methods: Twenty three patients, who had acute obstruction due to malignant left-sided colorectal cancer were divided into two groups, (group A) 11 patients who underwent surgical resection after insertion of SEMS and 12 patients (group B) were managed with emergency colonic resection. The two groups were compared for the incidence of primary anastomosis, hospital stay, duration of intensive care (/CU stay), post-operative morbidity and mortality. Results: Both groups had similar age, pre-operative co-morbidity and stage of disease. Placement of SEMS was successful in group A, one patient had migration of stent distally after 2 days and was removed manually. All the other patients underwent elective operation with primary anastomosis (100%). In group B primary anastomosis was performed in 10/12 patients (83.5%) versus (100%) in group A. The difference in the incidence of primary anastomosis was significant (p=0.047). There was a significant difference regarding the median postoperative hospital stays. Conclusion: When compared with emergency resection, insertion of SEMS as a bridge to surgery for obstructing left-sided colorectal cancer is associated with a higher rate of primary anastomosis  as well as a better outcome  in terms of hospital  stay and stay in the !CU.