Left-sided malignant colonic obstruction is one of the most difficult clinical problems; however, no studies compared the two most common used surgical approach laparoscopic and open colorectomy till now. The purpose of this study was to investigate the short- and long-term outcomes of laparoscopy and open colorectomy for left-sided malignant colonic obstruction. A total of 193 colorectal carcinoma patients (55 patients who underwent laparoscopic colorectomy and 138 who underwent open colorectomy) with left-sided colonic obstruction and surgical therapy, between May 2007 and March 2012, are included in the study. The short-term and long-term outcomes including curative resection rate, hospital stay time, complications, 1-, 3- and 5-year survival rates and recurrence rate, as well as recurrence-free survival rate were analyzed retrospectively. No significant difference was found between the laparoscopic and open groups about the short-term outcomes, such as the curative resection rate (81.82 vs. 78.99%, P=0.658), hospital stay time (24.22±17.09 vs. 24.19±14.76 day, P=0.990), the overall and respective complications (32.73 vs. 39.63%, P=0.674). Long-term outcomes, including 1-, 3- and 5-year survival rates (P=0.518), recurrence rates (P=0.320), and recurrence-free survival rates (P=0.988), were also indicated no significant differences between the two patient groups. Laparoscopy might not have advantages on left-sided malignant colonic obstruction compared with open colorectal resection in both short-term and long-term outcomes.