9630 Background: This study was performed to evaluate the clinical features and outcome of patients with Colorectal cancer (CRC) in Iran. Methods: All cases of CRC presented to a main countryside referral University hospital (SGH) for cancers in Teheran, Iran between June 20,2000 and January 3,2003 were retrospectively reviewed to determine age, gender, subsite distribution, early symptoms, ethnicity, type of the CRC and the chemotherapy management. Results: A total of 200 patients were included .114 patients (57.0%) were male and 86 were female (43.0%) .Age ranged from 13–90 years with a mean of 55.15+/− 14.5 years.16.5% of patients were below 40 years of age.The tumors were classified as : appendix (n=4), cecum ( n=7), Right Cancers (RC), from the cecum to hepatic flexure (n=1), hepatic flexure ( n=2), Transverse Colon (n=19), Splenic Flexure (n=3), Left Colon (LC) from the Splenic Flexure down to Sigmoid (n=6), Sigmoid ( n=16), Rectum ( n=117), Rectosigmoid & Rectal lesions (n=16), and Colorectal lesions without known locations (n=9). Non-Mucinous Adenocarcinoma was the most common (n=181, 90%), followed by Mucinous AC (n=15), SCC (n=1), Carcinoid (n=1), Melanoma (n=1), Signet ring carcinoma (n=1). The most common presenting symptom was Rectal bleeding ( n=68, 34.5%) . 37% of patients had anemia at the time of diagnosis. 130 of patients underwent chemotherapy and the combination of 5-FU and Leucovorin was predominanat. (n=104, 52%) Younger patients significantly had more Mucinous AC (p=.008) and took more 5-FU.(p=0.05) Conclusions: We have no reports from the Epidemiology of CRC in Iran since 1977. the data suggested a younger age distribution for CRC . we found no significant difference between age, gender and type of cancer with subsite distribution . Distal (left-sided) CRC was more prevalent. 30.5% of patients were diagnosed by screening studies which highly suggests the procedure. 1 out of 200 patients was ethnically Jews and because of high risk in these people with a population of 26,354 in a 61M in Iran, so more investigation is needed. Anemia was less common in our population. younger patients received medical attention and 5-FU medication earlier and more. No significant financial relationships to disclose.