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Context: Malignant bowel obstruction is a common complication in advanced cancer patients with abdominal or pelvic malignancy.Median survival after its onset ranges from 30 to 90 days.Objective: The aim of this study was to evaluate the efficacy and safety of Continuous 5-fluorouracil infusion in inoperable malignant bowel obstruction (MBO).Methods: Twenty-seven patients diagnosed with inoperable malignant bowel obstruction were treated with continuous 5-FU infusion (300 mg/m2 daily) dl-5, 8-12, q3w.The primary end point was symptom control (remission of obstruction).The secondary end point was the symptom control time and survival, and the tertiary end point was adverse effects.Results: Twenty-seven patients underwent the treatment.Pretreatment, 25/27 patients (92.6%) were nil per os, 2/27 (7.4%) drank liquids.After continuous 5-fluorouracil infusion, only 5/27 (18.5%) was still nil per os, 4/27 (14.8%) drank liquids, 5/27 (18.5%)ate soft solids, and 13/27 (48.1%) ate a full diet.The improvement in ability to eat using the scoring system was statistically significant (p < 0.0001).Median remission time of MBO was 125 days.Median survival was 153 days.Three-month survival rate was 63.0% and six-month survival rate was 48.1%.Treatment was well tolerated, with grade Ⅲ toxicities consisting of thrombocytopenia in one patient (3.7%), and mucositis in one patient (3.7%).Conclusions: Continuous 5-FU infusion is well tolerated and shows activity in inoperable malignant bowel obstruction.Continuous 5-FU infusion provides a rationale for exploring this association in the future.