Objective To investigate the clinical effect and feasibility of self-expandable metal stenting guided by ultra-fine endoscope in diagnosis and treatment of colon tumor with obstruction.Methods Retrospective analysis was performed on the clinical data of 22 patients with colonic tumor and obstruction treated by the method of self-expandable metal stenting guided by ultra-fine endoscope from June 2019 to December 2020.Results The success rate was 95.45%, the median operative time was (26.0 ± 7.2) min, 19 patients underwent one-stage surgery, none anastomotic complications, without surgical treatment was performed in 3 patients, and no recurrence of intestinal obstruction was found during 3-month follow-up.Conclusion Compared with the traditional X-ray assisted intestinal metal stent implantation via endoscopy, the treatment of colon tumor with obstruction by ultra-fine endoscopy guided self-expanding metal stent implantation can avoid the radiation injury of doctors and patients during the operation, reduce the risk of interventional indoor cross-infection, and reduce the medical costs, which is worthy of clinical promotion and application.