Colonoscopy-related perforation is a rare but serious complication. The type of perforation depends on whether it was caused by a diagnostic examination or as a sequelae to a therapeutic procedure. Although traditionally managed by surgery, endoscopic management is increasingly used. This review focuses on the currently available methods of endoscopic management following colonoscopy-related perforation, together with a brief review of their efficacy. With better development of endoscopic accessories such as through-the-scope and over-the-scope clips, and increasing experience by endoscopists, it is now recommended that endoscopic management should be the preferred initial treatment modality of colonoscopy-related perforation.