ABSTRACT: The authors of the article cite literature data on the annual incidence of the colon of about 2 million cases with a mortality rate of 25-30%, which is due to the growth of oncological diseases, varying degrees of equipment of institutions dealing with colorectal surgery, various techniques of performing operations, the method of forming anastomoses, and management of the postoperative period. At the same time, the colonic anastomotic leakage (CAL) is noted up to 20-30%. The authors analyzed in detail the current state of the CAL problem on the basis of the analysis, including the meta-analysis of a number of researchers, who state the influence of many factors, as well as the state of the patient's body in the development of this complication. The authors conclude that such a large number of factors, a number of which can be combined, as well as insufficient qualification of the surgeon, significantly complicate the task of developing recommendations for the prevention of CAL.