1603 Background: Asian Indian and Pakistani population living in the US (US-AIP) comprises 1.5% of total US population and is a rapidly growing minority group. Colorectal (CRC) is the third most common cancer in US-AIP reported in SEER database from 1988-2006. This is the first study reporting different epidemiologic and survival parameters of CRC in this population. Methods: Since 1988, SEER has been collecting and reporting data of US-AIP as a separate ethnic and race group. Using the SEER database including patients diagnosed with CRC from 1988-2006, we performed frequency analysis on demographics and treatment, comparing US-AIP, Caucasian (USW), Hispanic, and African- American (AA). Multivariate analyses and survival sessions (Kaplan-Meier, age-adjusted) were undertaken. Results: CRC accounts about 8% (859) of all cancers (10,833) in US-AIP reported in SEER database; is more common in male (59% vs. 41%, p < 0.001) with incidence rate of 39 per 100,000 (less common than USW, Hispanic and AA, p < 0.001). CRC is the fifth and seventh leading cancer in India and Pakistan respectively according to 2009 World Health Organization's data. Median age of diagnosis is significantly less in US-AIP (62 vs. 71 yrs, p < 0.001), more patients less than 50 yrs of age at diagnosis (26% vs. 11%, p < 0.001) with advanced stages (p < 0.001) and grades (p < 0.001) in comparison to other major US ethnicities. But overall, stage and gender specific 1-5 year survival is significantly better (p < 0.01 – 0.03) in US-AIP than other ethnicities in the USA. Cox regression analysis showed that age at diagnosis, stages, grades, marital status, and year of diagnosis were predictors of death. Relative risk (RR) of death increased with higher grades, stages and older ages. Conclusions: This is the first study analyzing the epidemiologic, biological and survival data of US-AIP. US-AIP change their demographics of CRC with migration. It shows clearly and identifies some unique age, stage and biological features of CRC in US-AIP. The difference in survival is intriguing. It could be due to differences in tumor biology, access to care and other factors. This study has potential implication in screening and therapeutic recommendation in US-AIP population. No significant financial relationships to disclose.