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Anastomotic leaks are the most serious complication of colo-rectal surgery, generating significant morbidity and mortality rates. We performed a 6-year retrospective study in which we included patients who developed anastomotic colo-rectal fistulas after resections for malignant disease. We assessed the risk factors for this complication, its management and results. Twenty-two patients aged between 34 and 82 years were enrolled, with an equal number of males and females (11). Following the surgical procedures, 4 types of anastomotic leaks resulted: ileo-colic (6 cases), colo-colic (8 cases), colo-rectal (5 cases) and low colo-rectal (3 cases). Conservative management was applied for 10 patients while the other 12 required surgical treatment. The overall mortality of this study group was 13.6%. Better optimisation of surgical procedures and preoperative patients' comorbidities might decrease the rate of this complication. Therapeutic management is not standardised but adapted to each patient's condition, but conservatory management should be initiated to all eligible patients. [ABSTRACT FROM AUTHOR]