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Background: Single-incision laparoscopic surgery (SILS) is an emerging modality for management of colorectal diseases. We incorporated this technique as a potential alternative to hand-assisted laparoscopic surgical (HALS) approach, which had been our preferred method. The goal of this investigation was to analyze intraoperative and short-term outcomes following SILS compared to HALS.Methods: Between July and November of 2009, 25 SILS colorectal procedures were performed and matched to HALS procedures based on 5 criteria: gender, age, BMI, pathology, and procedure. The procedures were performed by two colorectal surgeons at a single institution. Demographic, intraoperative, and postoperative data were tabulated and assessed (paired two-tailed Student’s t-test).Results: 50 patients (52% male) with a mean age of 57.7 years and mean BMI of 28.6 kg/m2 (range: 17.7-49.0 kg/m2) were matched. The most common procedure was a right hemicolectomy (76%), followed by sigmoidectomy and total colectomy (12% each). The median incision length was 3.5 cm and 6.0 cm for the SILS and HALS groups, respectively. On average, SILS required 27 more minutes compared to the HALS (148.1 min and 121.6 min, p<0.001). There were no intraoperative complications during either approach, and the mean estimated blood loss was lower for SILS. Three patients in the SILS group required conversion - two to HALS technique and one to conventional laparoscopic technique; while one patient in the HALS group required conversion to laparotomy. Mean length of stay was significantly shorter in the SILS group (2.7 days) compared to the HALS group (3.6 days), p<0.00001. There were no significant differences in postoperative complications.Conclusion: Single-incision laparoscopic surgery is a safe and feasible approach for colorectal resections. When compared to HALS, SILS results in a smaller incision size and reduced length of stay at the expense of longer operative times.