Abstract: Objective To evaluate the safty and efficacy of compression anastomosis clip(CAC) for bypass anastomosis in the operation of advanced malignant intestinal obstruction. Methods Forty-one patients who underwent intestinal bypass anastomosis or ileocolostomy between Apr 2006 and Mar 2008 were assigned randomly to use either CAC or manual suture. CAC group underwent intestinal bypass anastomosis or ileocolostomy with CAC, while manual group underwent intestinal bypass anastomosis or ileocolostomy with manual suture. The following parameters have been recorded: operative time; intestinal anastomosis time; anastomotic complication; first post-operation flatus and bowel movement; extrusion of clip device. Results The operative time,intestinal anastomosis time，the occurrence rate of postoperative complication and hospital stay in CAC group were all less than that in manual group,and the differences between two groups showed statistical significance（P<0.05）. One mortality was recorded in each group, but were not related to anastomotic procedure. Two groups had the similar results in recovery of bowel function（P>0.05）.The clip is expelled with the stool within 10~18 days. Conclusion It is safe and simple to use CAC for bypass anastomosis in the operation of advanced malignant intestinal obstruction, and CAC can reduce the trauma and pain, and improve the quality of life. This operation may be generally applied in clinical practice.