Introduction: Complicated colorectal cancer (CCRC) is a public health problem with a significant negative impact on morbidity and mortality. The surgical aspect is determined by the decision between: primary anastomosis or external intestinal derivation. Aim: Analysis of emergency surgical treatment results in complicated colorectal cancer. Material & Methods: Retrospective study of 98 patients with CCRC operated in emergency settings within Institute of Emergency Medicine (Chisinau), between 2015-2017, right-sided – 25(25.5%), transvers – 9(9.18%), left-sided – 64(64.94%), (p\0.01). Primary anastomosis – 68(69.38%), colostomy – 30(30.61%). Ratio M:F = 1.1:1, mean age – 63.96 ± 1.34 years. Results: 22(22.44%) patients had intestinal obstruction (IO) and peritonitis, 9(9.18%) of them with perforation, operated within 8 h; with IO – 25(25.5%), operated within 8-24 h; with partial obstruction – 43(43%), bleeding – 8(8.2%), operated within 2-5 days. Were performed hemicolonectomies: right-sided – 34(34.6%), including – 7(7.1%) extended, finalized with primary anastomosis – 28(82.4%) and ileostomy – 6(17.6%); left-sided – 48(48.97%), finalized with primary anastomosis – 40(83.3%), transversostomy – 3(7.5%), STEC – 5(12.5%) and in 16(16.3%) – Hartmann procedure. There were anastomotic leakage in 3(4.4%) case, right hemicolonectomy – 1(2.94%), left hemicolonectomy – 2(4.16%), which were fixed by relaparotomy and external derivation, one patient died. Mortality rate was 19.38%(n = 19), from which 8(11.8%) with primary anastomosis and 11(36.7%) with external derivations. Conclusion: Differentiated surgical approach in complicated colorectal cancer is influenced by the tumor‘s site and clinical features upon admission. Most of the patients showed signs of intestinal obstruction at admission (p\0.001), which explains the high rate of external derivations with higher morbidity and mortality rate.