The idea of external treatment of malignant bowel obstruction (MBO) by traditional Chinese medicine (TCM) was discussed based on multi-mode concept through reviewing relevant literatures and summarizing clinical practice experience. At present, TCM external treatment of MBO mostly limited to the combination of enema/anal drip and acupuncture, mainly including TCM enema/anal drip, acupuncture and moxibustion, and acupoint application. Under the background of comprehensive treatment of malignant tumors, it is recommended to adopt the thinking mode of “integrating disease differentiation and syndrome differentiation”. For elderly patients with advanced tumor in a critical condition manifesting cachexia, end-stage malignant tumor with MBO and having no surgical indications, it is recommended to select and apply TCM enema/anal drip, acupuncture and moxibustion, acupoint application, Tuina massage, fumigation and steaming, blood-letting and cupping and other external treatment methods in an early, whole-process and organic manner.