Abstract: The management of colorectal cancer has undergone substantial changes with advances in molecular biology and diagnostic technologies. The concept of precision medicine has gradually shifted traditional treatment strategies, which were largely based on anatomical staging and empirical approaches, toward biologically driven and individualized decision‑making. In recent years, refined molecular profiling has enabled key biomarkers such as KRAS, BRAF, and human epidermal growth factor receptor 2 to guide not only treatment selection but also the design of combination and sequential therapeutic strategies. Meanwhile, circulating tumor DNA and minimal residual disease assessment have emerged as promising tools for postoperative risk stratification and dynamic surveillance, offering new opportunities to optimize adjuvant therapy and early detection of recurrence. In the field of immunotherapy, immune checkpoint inhibitors have demonstrated robust efficacy in microsatellite instability‑high/deficient mismatch repair colorectal cancer, while ongoing efforts to overcome immune resistance in microsatellite stability tumors are expanding the potential scope of immunotherapeutic approaches. Within this evolving landscape, surgery remains indispensable; however, its role has been redefined from a purely technical procedure to a critical decision‑making component integrated throughout the multidisciplinary treatment pathway, with increasing emphasis on surgical quality and timing. The authors summarize recent advances in precision diagnosis, monitoring, immunotherapy, and surgical management of colorectal cancer, and discusses their implications for contemporary clinical practice.