We studied a clinical significance of peritoneal carcinomatosis to metastatic recurrent colorectal cancer with ileus. The subjects were 16 patients with ileus confirmed in 1995-2005. Of the 16 patients, 7 had surgical treatment and the other 9 had conservative treatment. The median survival time of the 16 patients was 98 days; the 7 patients of surgical treatment were 235 days; the 9 patients of conservative treatment were only 67 days. Only 4 patients survived more than 200 days. These 4 patients had surgical treatment, and were the cases where no peritoneal fluid was confirmed and the metastatic tumor was excised. However, only 2 patients improved in QOL. The 3 patients in the surgical treatment were aggravated. An optimum resection may prolong a survival time and patient's QOL could be improved. On the other hand, an extended resection may contribute to shorting a survival time.