In this study, we evaluated the safety of primary repair of colon injury in a low-volume tropical hospital setting. Between 1998 and 2005, 18 consecutive patients who underwent emergency operation for civilian traumatic colon injury were studied. The main outcome measures were the mortality and morbidity rates and the total length of the hospital stay. The mean hospital stay for one-stage repair was 12 days versus 29 days for the two-stage procedure, which was a significant difference (p = 0.009). There was no death reported from this study. There was no significant difference in postoperative septic complications between the one-stage and two-stage procedures. One-stage repair of colonic injury is a safe and cost-effective option for selected patients in the tropical hospital setting.