Whether cholecystectomy increases the risk of colorectal cancer (CRC) has long been a topic of interest in the field of digestive surgery. Post-cholecystectomy alterations in bile acid metabolism lead to increased secondary bile acid production and gut microbiota dysbiosis, while abnormalities in gut motility and immune regulation create favorable conditions for CRC development to some extent. The right half of the colon, particularly the proximal colon, is considered the primary risk site, with more pronounced effects in specific populations. However, current research in this area still faces limitations such as small sample sizes, confounding surgical indications, insufficient disease understanding, and failure to account for population heterogeneity. Therefore, existing evidence is insufficient to support the classification of cholecystectomy as an independent risk factor for CRC. Future studies should focus on conducting more rigorously designed, long-term prospective cohort studies and meta-analyses to eliminate confounding factors, further exploring the causal relationship between cholecystectomy and CRC at a systemic level. This will aim to provide more reliable evidence-based guidance for clinical decision-making, improving surgical outcomes and overall quality of life for patients.