The use of self-expanding metal stents (SEMS) in the colon is now becoming more commonplace. These devices can be employed to decompress large bowel that has become obstructed from either benign or malignant disease. Many studies in the past year have validated the use of colonic SEMS to allow preoperative bowel preparation in resectable patients, or as an alternative to surgery in those requiring palliative therapy alone. Laser therapy has also gained new ground in recent months because it has been shown to help in recanulation of obstructed bowel to aid in SEMS placement. In addition, laser therapy alone can be used to treat some colonic lesions that had formerly been treated surgically.