Self expanding metal stents (SEMS) are an established treatment in the management of malignant obstructing lesions throughout the gastrointestinal tract. SEMS have been utilized both as palliation in and as a bridge to surgical resection for malignant colonic obstruction. Many studies have demonstrated that placement of SEMS for malignant colonic obstruction is both efficacious, with high technical and clinical success rates, and safe with a low complication rate. In contrast, there is a paucity of data on the role of SEMS in the management of benign colonic obstruction, an indication which remains controversial. This review outlines the most recent developments in colonic stenting, their current indications, and the evidence to support their use in these indications.