The complication rate and mortality rate of traditional emergency surgery for acute obstructive colorectal cancer are very high. Self-expanding metal stent (SEMS) as a bridge to surgery can rapidly decompress the intestinal tract and radical surgery can be performed after the patients’ general condition improve. This technology has been widely developed, but its safety is still controversial, mainly related to the risk of SEMS implantation and its impact on the long-term survival of patients. This article will introduce the rationale, pathophysiology, short-term safety and long-term oncology safety of SEMS implantation, in order to provide basis for clinicians to choose treatment methods.