Purpose: Carcinoma of the splenic flexure is uncommon and it is associated with a high risk of obstruction. However, survival after resection of this tumor is controversial. The aim of this study was to evaluate cancer specific long-term survival after surgery for splenic flexure cancers compared to survival for the colon cancer at other sites. Patients and Methods: Of 500 patients undergoing surgery for colon cancer, 16 (3.2%) had cancers of the splenic flexure. Clinicopathological features and cancer specific longterm survival after curative resection were evaluated. Results: Splenic flexure carcinomas were found to be associated with a high risk of obstruction (4 out of 16; 25.0%) and a high risk of penetration/perforation (1 out of 16; 6.2%) compared with colon cancers at other sites (P <0.0001 and P=0.0128, respectively). Operative mortality rate for patients with carcinomas of splenic flexure was significantly higher than that of other sites (6.3% versus 0.8%; P=0.0319). However, resection for splenic flexure tumors was usually possible, and there was no difference in cancer specific long-term survival after surgery between the patients with splenic flexure cancers and the other site colon cancers (P=0.3505). Conclusions: Carcinoma of the splenic flexure has a similar prognosis to colon cancer at other sites.