Sigmoid ulcerative lesions its benign and malignant difference is mainly manifested in the enteroscopic morphology, disease severity, treatment modality, treatment prognosis. Benign sigmoid ulcers have a smoother ulcer base, neat edges, smaller ulcers and shallower depths under enteroscopy. Its severity is generally mild, and can be treated by diet control and other general treatment or drug treatment; serious ulcers can appear perforation, usually need to be surgical treatment, but the overall prognosis is generally better. Malignant sigmoid colon ulcer, i.e. sigmoid colon cancer, has an irregular shape under colonoscopy, which is vessel-shaped or crater-shaped, with larger ulcers, deeper depth and uneven bottom. Generally speaking, it is more serious and should be treated with surgery immediately after diagnosis, and if there is metastasis, lymph node clearance or radiotherapy should be performed, and the overall healing is generally poor. In conclusion, if you find sigmoid ulcers, you should go to the hospital in time to get a clear diagnosis and treatment under the doctor’s guidance.