 This prospective, randomized, multi-center trial aims to investigate the optimal approach for managing left-sided colon cancer with acute colonic obstruction in a comprehensive manner by comparing emergency resection and bridge-to-surgery approaches. The study will enroll 468 patients, providing a cohort of 420 evaluable patients, with an equal distribution of 210 patients in each treatment arm. The primary endpoint is 120-day mortality, allowing for consideration of the time interval between diverting stoma and resection. The findings derived from this trial have the potential to reshape the current clinical approach of emergency resection for obstructive left-sided colon cancer by favoring the bridge-to-surgery practice, provided that a reduction in morbidity can be achieved without compromising the oncological long-term outcome. This article was authored by Matiu Pico, Marius Dissola, Olga Radulova-Malsberger, and others.