The role of laser photocoagulation in the palliative treatment of gastrointestinal tumors was investigated in a multicenter inquiry involving seven laser centers and 181 patients. Patients with colorectal malignancies were divided into three groups: those referred for palliation of obstruction (N = 60), those referred for bleeding (N = 81), and those referred for obstruction and bleeding (N = 40). Good palliation was obtained in 89%, with a complication rate of 9.4% and a laser-related mortality of 1.1%. Tumor response, complication rate, mortality, and duration of survival were less favorable in the group with obstructing tumors when compared to those with bleeding or with bleeding and obstruction. Laser phototherapy should play a role as an alternative to surgery in selected patients with bleeding and/or obstructing colorectal cancer.