Local excision of colorectal tumour may be palliative or curative. Recent advances in minimal access techniques have allowed curative excision to be offered to a wider range of patients. Absolute indications for potentially curative local excision include mobile tumours, T-1 tumours (assessed by ultrasonsography), well or moderately differentiated histology (determined by biopsy) and tumour size less than 3 cm. Relative indications include T-2 and T-3 tumours (by ultrasonography,), poorly differentiated histology (by biopsy) and tumour size greater than 3 cm depending on patient fitness. The rationale for these recommendations is described in detail.