Objective: To investigate the efficacy of stent placement for acute intestinal obstruction combined with advanced colorectal cancer and widespread metastases. Methods: The clinical data of 67 patients with acute intestinal obstruction and colorectal cancer with widespread metastases treated from March 2005 to September 2011 were retrospectively analyzed. Of them, 30 cases received stent placement (stent placement group) and 37 cases underwent conventional emergency surgery (conventional surgery group). The clinical variables between the two groups of patients were compared. Results: In stent placement group, compared with conventional surgery group, the surgical success rate (86.7% vs. 97.3%), operative time (4.32 h vs. 4.78 h) and postoperative mortality within 30 days (0.0% vs. 11.1%) showed no statistical difference (all P>0.05), but the intraoperative blood loss (76.6 mL vs. 274 mL), length of hospital stay (6.7 d vs. 15.5 d) and overall incidence of complications (19.2% vs. 52.8%) were significantly reduced (all P<0.05). There was no significant difference in median survival time (11.4 months vs. 10.7 months) between stent placement group and conventional surgery group (P<0.05). Conclusion: Stent placement has demonstrable efficacy in treatment of acute intestinal obstruction combined with advanced colorectal cancer, with better curative effect, and is safe and more reliable, so it is recommended to be used in clinical practice.