AbstractEight hundred thirty‐six patients with carcinoma of colon and rectum were treated surgically in the Ichilov Medical Center from 1968 to 1975. Forty‐five patients (5.38%) suffering from perforative carcinoma were followed up. It was found that the treatment of choice for perforative carcinoma of the descending colon is primary resection without primary anastomosis. In ascending colon perforation the treatment of choice is primary resection with primary anastomosis. Thus aggressive surgical procedures afford the patient the best chance for smoother postoperative course and recovery. In patients surviving the operation, the survival time is not influenced by the type of perforation but by the stage of tumor invas