We report a 50-year-old man with local recurrence of descending colon cancer with ileus obstruction and brain metastasis, 2 years 6 months after initial resection due to perforation of descending colon cancer(Hartmann procedure, D2 lymph node resection, Stage II, tub2). He complained of left upper abdominal pain and abdominal fullness. He also complained of paresis of the right upper extremity and of experiencing convulsions 1 month before admission. He was diagnosed with local recurrence of descending colon cancer, based on findings of contrast radiography and the presence of colonic fiber. We subsequently performed transanal decompression as a bridge to surgery and performed partial resection of the local recurrence in the anastomosis at the descending colon and ileum involved with the cancer 2 weeks after decompression. In addition, multiple lung and liver metastases, and solitary brain metastasis(2.5 cm in size located in the left side of the parietal region) were detected by cerebral plain computed tomography. However, he refused both chemotherapy after surgery, as well as further surgery and/or radiation therapy for the brain metastasis. He desired to return to his home as soon as possible. In order to improve his quality of life(QOL), in-home treatment involving the best supportive care(BSC)conservative therapiesincluding, anticonvulsant and anti-intracranial hypertension drugs-were administered to prevent brain metastasis symptoms, such as paresis of the right upper extremities and convulsions. He was discharged from our hospital 14 days after surgery. Regrettably, he died due to bronchial asthma 75 days after palliative surgery in his home.