Most patients with stage IV colorectal cancer have a poor prognosis,but numerous palliative modalities are available today. When a cure is no longer possible, treatment is directed toward providing symptomatic relief. The data leave little doubt that surgical resection may provide good palliation. Although resection has been the mainstay of palliative care, an individualized multidisciplinary approach, which may involve both surgical and nonsurgical modalities, is probably the best current option.