The minilaparotomy approach is feasible for the resection of colon cancer. This study aimed to compare the clinical and oncological outcomes of minilaparotomy and laparoscopic approaches in patients with colon cancer. We performed a retrospective analysis of consecutive patients undergoing minilaparotomy or laparoscopic resection for colon cancer from January 2009 to December 2014. There were 376 patients with colon cancer. Seventy-one patients were excluded. The remaining 305 patients were allocated to the minilaparotomy (n = 146) group or laparoscopic group (n = 159). The demographic data of the two groups was similar except for body mass index. The time to first bowel movement (P = 0.000) and the hospital stay (P = 0.005) were less in the laparoscopic group. Compared with the minilaparotomy group, the mean operation time was longer and the costs higher for laparoscopic group (P = 0.000). The morbidity, mortality, and local recurrence were comparable between the two groups. The 5-year overall and disease-free survival rates were also similar (overall survival is 75.3 vs. 72.9%, P = 0.648; disease-free survival is 66.2 vs. 70.2%, P = 0.914). The minilaparotomy approach was safe and equivalent to laparoscopic approach for patients with colon cancer. It is an alternative to the laparoscopic approach in selected patients.