Background: Brain metastasis (BM) is a rare but serious neurologic complication of colorectal cancer (CRC). The Disease Specific Graded Prognostic Assessment (DS-GPA) which is based solely on Karnofsky performance scale (KPS) is a commonly used prognostic index in patients with BM. We evaluated DS-GPA and other potential prognostic factors for overall survival (OS) in CRCBM at our institution. Methods: With IRB approval, the Cleveland Clinic Brain Tumor and Neuro-Oncology Center’s database was used to identify CRCBM patients treated between 2002 and 2014. OS from the diagnosis of CRC BM was the primary endpoint. Cox proportional hazards models with stepwise variable selection were used to identify independent prognostic factors. Results: Ninety four patients with median age of 60 years (range; 32-87), were included for analysis. KPS was 90-100 in 35 patients (38%), 70-80 in 35 (39%) and <70 in 20 (23%) patients. Single BM was noted in 53 (56%), 2-3 BM in 25 (27%) and >3 BM in 16 (17%) patients. Eighty nine patients (95%) were symptomatic at diagnosis. Forty nine(52%) patients had supratentorial BM, 25(25%) had infratentorial BM and 20 (21%) had both supra-and infratentorial BM at diagnosis. Initial therapy included whole brain radiation (WBRT) in 31 (33%), stereotactic radiosurgery (SRS) in 22(23%), WBRT + SRS in 11(12%), surgery (S) in 2 (2%), S+SRS in 6 (6%), S+WBRT in 14(15%), S+SRS+WBRT in 1(1%), while 2 patients received only chemotherapy and 5 underwent observation. Median OS from diagnosis of BM was 5.5 months (95% C.I. 3.5-7.5). In multivariate analysis KPS and number of BM were independent predictors of OS. Combining these factors a revised GPA with three groups was defined: unfavorable (total points ≤3), intermediate (4-5), and favorable (≥6 points) with median OS of 2.8, 6.1 and 14.7 months, respectively. Conclusions: A revised DS-GPA for CRCBM based on KPS (performance status) and number of BM is proposed.