There has undoubtedly been progress in our management of both primary and advanced or recurrent colorectal cancer. Surgery remains the mainstay and most important modality. However, adjuvant therapy for patients thought to have had a “curative” resection may be beneficial. Promising approaches include systemic treatment involving 5-fluorouracil in conjunction with levamisole and portal-vein infusion in conjunction with 5-fluorouracil. In addition, radiotherapy has been shown to reduce local recurrence rates. For advanced or recurrent disease, several novel approaches are beginning to show promise, including enhancement of the effect of 5-fluorouracil by biochemical modulation with, for example, leucovorin. In addition, the combination of immunotherapy with chemotherapy may result in an enhanced response. These approaches deserve further study.