The different palliative procedures in incurable colorectal cancer are critically reviewed. In regard to the progress in operative and non-operative management the aims and possibilities have to be newly defined. The alternative, colostomy or enteroanastomosis, is unable to satisfy higher demands. This also means a tendency to aggressive resection therapy in colonic and proximal rectal carcinoma as well as combined local surgical and radiological treatment in distal rectal cancer. In emergency cases the minimal intervention necessary has to be planned in preparation for a more radical effort later on. The role of chemotherapy in colorectal cancer is still not precisely defined. In complications where surgical or radiological palliation is hopeless, the limited success of a combined therapy with 5-fluorouracil and MeCCNU seems justified.