['The authors present their experience of colonoscopic perforation and its management, with an analysis of factors affecting outcome.', 'During the last 10 years, 22 cases of colonoscopic perforation (CP) were identified in two different institutions. Multiple logistic regression analysis was used to identify significant predictors of morbidity and mortality.', 'Morbidity and mortality rates were 31% and 13.6%, respectively. Prompt diagnosis was the most powerful predictor of outcome of CP. Multiple logistic regression analysis showed that morbidity and mortality were significantly related to a delay in diagnosis of more than 24 h (P = 0.03 and P = 0.04).'] Is promptness of diagnosis the main prognostic factor after colonoscopic perforation?