Background: Colorectal cancer surgery in extreme elderly population ( ≥80 years) is a growing problem and a subject in question. Experiences and results in this scenario are limited. Methods: Medical records of patients ≥80 years old hospitalized in General Surgery Department in Vega Baja Hospital between January 1, 2008, and December 31, 2012, were retrospectively reviewed. Patients diagnosed with colorectal cancer (CRC) were selected. Data regarding comorbidity, treatment performed, complications, and survival were collected. Results: 95 patients (74 colon, 21 rectum) were identified: median age 83.9 years (80-93), 64.2% males. 93.7% of patients were operated on: median hospital and post-operative stay of 14.1 and 11 days, respectively; curative intention surgery 82.1%. 5.4% of patients were treated with interventionist procedures, and 2.1% of patients in a conservative way. 17.9% and 4.2% of patients came up with early and late complications, respectively. Early and late mortality occurred in 9.5% and 3.2% of patients, respectively. There was no statiscally significant association between number of comorbidities and morbi-mortality. Early complications were more frequently associated to bronchopathy (33%) or cardiopathy (25.9%), while late complications were to diabetes (15%), congnitive disorders (12.5%), and cardiopathy (7.4%). Late mortality ocurred more frequently associated to diabetes (5%) and cardiopathy (3.7%). Colon cancer was more frequently associated to early complications and early and late mortality, maybe explained with more unscheduled surgeries. By March 2014, with a median folluw up of 43.8 months, 37.9% of patients are alive free of relapse, 2.1% are alive with disease, 26.3% had died of cancer, 10.5% had died of surgery related complications, and 23.2% of patients had died of other causes. Conclusions: Certain comorbidities and not the addition of them were associated with morbidity and mortality due to CRC surgery. Personalizing CRC treatment in a extreme elderly population may result in extended survival in this increasing subgroup of patients.