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Laparoscopic-assisted colectomy with an extracorporeal anastomosis is associated with a higher conversion rate for left-sided colon tumors. We hypothesized that a totally intracorporeal laparoscopic colectomy (TILC) would minimize operative conversion and morbidity. We conducted a case-control study comparing TILC for left-sided and right-sided tumors with matching based on age and ASA status. TILC was performed for 105 colon tumors with an overall conversion rate of 6.5%, a complication rate of 22%, and median length of stay of 5 days. There were 35 patients undergoing TILC for left-sided colon tumors and 70 patients undergoing TILC for right-sided colon tumors. Operative conversion for left-sided TILC (6%) was similar (P=0.78) to right-sided TILC (7%). Complication rates for left-sided TILC (23%) were no different (P=0.87) compared with right-sided TILC (21%). Length of stay for left-sided TILC (5 d) was comparable (P=0.17) to right-sided TILC (5 d). Laparoscopic left colectomy can be successfully performed with equivalent results to laparoscopic right colectomy by using a totally intracorporeal technique.