ABSTRACT Introduction The management of colorectal cancer in the elderly patients is becoming a major problem of public health. The principles of treatment of colorectal cancer in patients aged 70 years old and over are the same as those of younger ones, but therapeutic indications should be adjusted according to physiological age, general condition, and the existence of co morbidities. Methods In this retrospective study, we reviewed 62 cases of colorectal cancer in patient aged 70 years old and over admitted in the medical oncology unit of HASSAN II university hospital between January 2009 and January 2012. The aim of this study is to determinate epidemiologic, clinical and therapeutic aspects of this disease in the elderly Moroccan population. Results 62 cases of colorectal cancer were diagnosed in patients aged 70 years old and over representing 27, 5% of all colorectal cancers. 70% of our patients are aged between 70 and 74 years old (n= 43), 20% between 75 and 79 years old, and 10% 80 years old and over. 20% of cases had antecedent of cardiovascular disease, and 8 % had a history of cancer family. The average time of diagnosis was 7.3 months, the clinical symptoms were mainly rectal bleeding (53%), abdominal pain (43%). 37 % of the patients were metastatic at the diagnosis (n=23), sites of metastasis were liver in 10 cases (43%), lung in 7cases (30%), peritoneum in 6 cases (26%), lymph nodes in 5 cases (21%). 20% of patients (n=13) presented a stage III disease, stage II was noted in 35% (n=22), and stage I in 6% (n=4). Left resection of the colon was performed in 24 % of cases, right hemi-colectomy was done in 22%, surgery of rectum was performed in 20%, and metastatic liver resection was done in 5% of all metastatic patients. Preoperative concomitant chemo radiotherapy was performed in 13% for lower and middle rectum. Adjuvant chemotherapy based on Capecitabine alone was administrated in 12 cases, and XELOX in 4 cases, with 25% of diarrhea (n=4), 18 % of hand and foot syndrome (n=3), 18% of non-febrile neutropenia (n=3), and 12% of peripheral neuropathy (n=2). 11% of our patients received metastatic chemotherapy based on XELERI+BEVACIZUMAB (n=7) with 2 cases of diarrhea grade 2, 11% patients received chemotherapy based on XELOX with one death secondary to thrombocytopenia grade 4 after first cycle, and 3% chemotherapy with CAPECITABINE alone. We opted for no treatment in 11% of patients (n=7): Cardiac failure in four cases, 2 cases because of deterioration of performance status, and terminal renal failure in one case. Conclusion All patients with colorectal cancer aged 70 years old and over should receive the most appropriate treatment thought to be effective and safe, according to their biological age and co morbidities. Geriatric assessment is essential in the care for elderly patients with colorectal cancer.