A 53-year-old man undergoing painless colonoscopy for long-term diarrhea. After colonoscopy withdrawing to the sigmoid colon, a local perforation was found, about 3 cm in size, oval in shape. We used a two-channel endoscope and grip to pull the edges of the intestinal wall on both sides of the perforation site to close together, and then repair the 3 cm oval perforation of the colon through multiple ordinary titanium clips. The patient had no obvious infection after surgery and recovered well after 1 month of follow-up. Preliminary experience has shown that using multiple titanium clips under dual-channel endoscope to zipper suture can effectively repair 3 cm iatrogenic colonic perforations.