Chronic myelogenous leukemia (CML) is a pluripotent stem cell malignancy with an incidence of 1.3 per 100,000. Occasionally this uncommon disease occurs concomitantly with other neoplasia including various lymphoproliferative disorders. Its association with solid tumors, especially in young people, is decidedly rare. We report the simultaneous occurrence of CML and signetringed adenocarcinoma of the rectum in a 20-year-old male. A review of the literature pertinent to this topic will be briefly discussed, emphasizing characteristics of rectal carcinomas in younger age-groups as well as the unexpected association of CML with solid tumors.