Objective:To analyze the clinical and pathological characteristics,surgical complications and prognosis of colorectal cancer (CRC) in the elderly patients,and discuss the surgical treatment for them. Methods:The clinical and pathological data of 266 CRC patients over 75 years old accepted surgical treatment between January 1985 and December 2003 in Cancer Hospital of Fudan University were analyzed retrospectively. Results:Among 266 patients,the age of 151 males and 115 females ranged from 75 to 91 years old.The rectum and sigmoid colon were the most popular sites in the elderly patients (69.2%),but still there were 22.2% of patients with tumors located in the right site of colon.Ninetyfour patients (35.3%) had complicated diseases before operation,such as cardiovascular disease and diabetes mellitus.Two hundreds and fifteen patients (80.8%) accepted radical excision while 35 patients (13.2%) accepted palliative resection.Thirty patients (11.3%) had postoperative complications,such as intestinal obstruction,haemorrhage,infection and so on. Among them,3 patients (1.1%) died several days after operation.The overall 5year survival rate was 51.3%. Conclusion:Though the elderly CRC patients have more complicated diseases before operation and more postoperative complications,the operative mortality is still lower if much more attentions are paid during operation.Also they have the 5year survival rate more than 50%.So the surgical treatment shouldn’t be ignored in the elderly CRC patients.