PURPOSE: Brain metastasis is infrequent in colorectal cancer patients. The purpose of this study was to analyze the clinical characteristics including the survival, type of treatment, and metastatic patterns of brain metastasis in colorectal cancer. METHODS: Between January 1993 and September 2002, we analyzed 2,019 surgical patients with colorectal carcinoma operated at Korea Cancer Center Hospital. Among these patients, 13 patients were identified with metastatic colorectal cancer to the brain. The medical records of these patients were reviewed retrospectively and survival analysis was performed. RESULTS: During the study period, the incidence of brain metastasis of colorectal cancer was 0.6%. Male-to-female ratio was 1:1.6. Mean age was 55.2+/-9.7 years and median age was 56 years (34~67years). The most frequent primary tumor site was the rectum (11 cases, 84.6%). and the most frequent symptom of brain metastasis was headache. According to the TNM staging system, there were 1 case in stage II, 8 cases in stage III, and 4 cases in stage IV at the time of initial diagnosis of colorectal cancer. Brain metastases were often occurred concurrently with lung metastases (9 cases, 69.2%), otherwise solitary brain metastasis was found in 4 cases. Between the diagnosis of primary cancer and the diagnosis of brain metastasis, the mean interval was 25.9+/-6.9 months and the median interval was 16 months (5~97) in stage II and III patients. The mean survival time after the diagnosis of brain metastasis was 18.5 months for patients who underwent surgery and 3.3 months for patients who received non-surgical therapy. CONCLUSIONS: Brain metastasis of colorectal cancer is relatively uncommon and the incidence is significantly low, commonly more or less than 1%. It is often accompanied by pulmonary metastasis. The results of this study show that surgical resection may increase the survival of these patients. Though inability to the awareness of the possibility and early diagnosis of brain metastasis in colorectal cancer could affect the poor prognosis, aggressive treatment in suitable cases might enhance the survival for this group of patients.