Lymph node metastasis of sigmoid colon cancer should be evaluated for the possibility of radical surgery; if radical surgery is possible, surgery combined with postoperative adjuvant chemotherapy is preferred; if radical surgery is not feasible, then comprehensive treatment is mainly adopted. Lymph node metastasis in sigmoid colon cancer indicates that the disease has progressed, if there is the possibility of radical surgery, it is recommended to perform tumor resection + regional lymph node dissection, and postoperative adjuvant chemotherapy can reduce the risk of tumor recurrence and metastasis. Commonly used chemotherapeutic drugs include oxaliplatin, capecitabine, 5-fluorouracil and so on. If the patient’s health condition is poor, single-agent chemotherapy can also be performed, and 5-fluorouracil or capecitabine are commonly used. If the patient is assessed to be unsuitable for radical surgery, a combination of treatments, including chemotherapy, radiotherapy, targeted therapy, immunotherapy, etc., will be used. In some patients, neoadjuvant therapy may result in downstaging of the tumor, thus meeting the indications for radical surgery. If acute intestinal obstruction, intestinal bleeding and other complications occur, palliative surgery can also be performed to alleviate the symptoms. If lymph node metastasis is found in sigmoid colon cancer, it is suggested that patients should go to hospital as early as possible for consultation, and ask professional doctors to fully evaluate their conditions and make scientific treatment plan.