Relevance. The global trend of an increase in the number of elderly and senile patients leads to the fact that the proportion of patients of older age groups entering cancer centers will also increase. Colorectal cancer occupies one of the leading positions in terms of morbidity. One of the unmodifiable risk factors for colorectal cancer is age. Every year, both in Russia and in the world, more and more cases of this pathology are recorded in elderly and senile patients. Significant advances have been made in the diagnosis and treatment of this pathology, but further research is required to study colorectal cancer in gerontological patients. Objective: to study the age-related characteristics of the course of colorectal cancer in patients of older age groups. Materials and methods: The study was carried out by means of a retrospective analysis of 182 clinical cases of colorectal cancer in elderly and senile patients according to the WHO classification. Results: The most common morphological type of tumor was adenocarcinoma 97.9%, 64.5% had high tumor differentiation (G1). Most often, the tumor was localized in the rectum - 47.8%. Colon cancer was diagnosed at stage III (IIIA, IIIB, IIIC) (T (any) N1.2M0) - in 47.3%. At the pre-invasive (ТisN0M0) stage of the tumor process in 2 patients (1%). All patients had cardiovascular pathology of varying severity, and in 86.7% of cases there was a comorbid pathology. Conclusions: Patients with colorectal cancer of elderly and senile age often had an increased body mass index, the tumor, as a rule, was localized in the sigmoid or rectum. The most common morphological type was highly differentiated adenocarcinoma. All patients had concomitant pathology, the overwhelming majority had comorbid pathology.