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Objective Through retrospective analysis of the neonates with colon perforation caused by necrotizing enterocolitis. to explore the best choice of surgical methods. Methods Neonates with colon perforation caused by necrotizing enterocolitis from May 1.2018 to May 1.2020 were selected as the research objects, and they were divided into resection group (control group. n=21) and repair group (observation group.-26). The curative effect and clinical outcome were analyzed by SPSS20, 0 soft ware. Results The emergency operation time of the observation group was significantly shorter than that of the control group. while the inflammatory recovery time and the ostomy closure time of the observation group were longer than those of the control group: There were no statistically significant differences in mechanical ventilation time, feeding time, parenteral nutrition time-hospital stay time and postoperative complications between the two groups (P-0, 04.0. 01.-0.01). Conclusion Both methods can be used as the treatment of colonic perforation caused by necrotizing enterocolitis in neonates. The choice of surgical methods de pends on the state of the newborn at the time of surgery. Enteroplasty is an option for neonates with poor basic conditions and un stable hemodynamics, while enterotomy is an option for neonates with stable vital signs. [ABSTRACT FROM AUTHOR]