It has been suggested that emergency colorectal surgery should be carried out by specialist colorectal surgeons. The aim of this study was to analyse the effect of specialty interest on patient outcomes within a district general hospital setting. Methods: Data were collected for patients who underwent emergency colorectal surgery in the period June 1998-June 2003. The primary outcome was 30-day mortality. Secondary outcomes were intraoperative, postoperative surgical and systemic complications and late complications. Subspecialty interest was validated by studying the volume of colorectal procedures performed per consultant per year over the study period. Results: Data were accessed for 358 patients over the study. Comparison between the patients operated by surgeons with subspecialty colorectal interest (n = 132) and others (n = 226) revealed no significant differences between the two groups for gender, ASA status (P = 0โข15), indication for surgery (P = 0โข30) and type of procedure. There was no difference in the 30-day mortality between the two groups (P = 0โข55). Subspecialty interest was not found to be a determinant of 30-day mortality on univariate and multivariate analysis. While there was a higher incidence of postoperative systemic complications in the non-colorectal group the difference was not significant (P = 0โข09). This may be explained by the finding that the patients in the non-colorectal group were of a significantly higher age (P = 0โข02). Conclusions: Outcomes for patients operated by noncolorectal surgeons are comparable to those of colorectal surgeons. However, the results should be interpreted with caution as nearly all the surgeons were trained in the pre-Calman era.