PURPOSE: Since the first case of bone metastasis of a rectal carcinoma was reported by Curling in 1870, bone metastasis in primary colorectal cancer has remained uncommon event. The aim of our study was to gain insight into the clinical characteristics of bone metastasis of colorectal cancer. METHODS: This is a 10-year retrospective study that covers patients with bone metastasis of colorectal cancer in the Department of Surgery, Korea Cancer Center Hospital, from Jan. 1993. RESULTS: In a total of 1461 cases of primary colorectal cancer treated in the same period, the clinical analysis was possible in 1356 cases. Of these, 53 cases showed bone metastasis. The incidence of bone metastasis was 3.9 Thirteen cases (25%) had bone metastasis only whereas 40 cases (75%) had bone metastasis combined with metastases of other organs. The most frequent site of bone metastasis was the vertebral bone (38, 71.7%), especially the thoracic spine (21, 39.6%). The median survival after onset of bone metastasis was 4.4 months, including 9.8 months in the bone-metastasis-only group and 3.5 months in bone metastasis with other-site- metastasis group. However, there was no significant difference in survival rate from the onset of bone metastasis between the two groups (P=0.3876). CONCLUSIONS: If the colorectal cancer patient has complaint of bony pain, bone metastasis should be considered even though it is a rare event. However, most cases of bone metastasis occur with metastases of other organs. Management is often limited to simple procedures intended to relieve pain in the terminal phase of the disease.