There is an increasing body of evidence to suggest that geriatric patients can benefit from and tolerate standard chemotherapy similar to younger patients in the settings of both early and advanced stage colorectal cancer. Assessment of this expanding population requires more comprehensive evaluation in addition to routine history, physical examination, and laboratory tests. Specific considerations of their physiologic functional changes will help physicians better manage these patients. Ongoing studies are now designed to better understand the decision-making process, safety profile, and efficacy of various treatment regimens in geriatric patients.