Background: Stage IV colon cancer has a dismal prognosis with a 5-yr survival rate of only 14%. The role of liver metastasectomy is well established. However, it is not clear if there is a survival benefit for metastasectomy in cases of extrahepatic disease. Methods: We conducted a retrospective cohort study, US hospital-based. The NCDB version 2017 was accessed. Exposure variable: metastasectomy for extrahepatic distant disease, analyzed as binary. Outcome: overall survival. Kaplan Meier curves and log rank test were used for survival analysis. The primary endpoint was to estimate the association between metastasectomy and survival. Covariates demographic factors, age, sex, race, insurance status, site of metastatic disease – lung, liver, bone, brain. A Cox proportional hazards model was used to evaluate the impact of metastasectomy of extrahepatic disease in patients with stage IV colon cancer. 95% confidence intervals and p values of less than 0.05 were used for statistical significance. Missing data as handled with complete and available case analysis. Statistical analysis was done using Stata 16. Results: A total of 68,334 adult patients with stage IV colon cancer diagnosed in from 2010 -2016 were included in the final analysis. Median age was 64 years (SD 14.1). Prevalence of metastases in this stage IV population was as follows: Liver 72.12%, Lung 20.12%, Bone 5.06%, Brain: 1.6%. A total of 10,595 patients (15.5%) had metastasectomy. Median overall survival were as follows: Lung, 21.59 months with surgery vs 8.41 months no surgery. Bone, 7.03 mo vs 4.53 mo respectively; Brain 9.3 mo vs 3.15 mo; Liver 33.28 mo vs 10.97 mo. In univariate analysis, patients with lung metastases had an improved survival if they had metastasectomy (vs no surgery, HR 0.58, p < 0.0001, 95% CI 0.52 – 0.60). The same benefit was observed in patients with bone (HR 0.80, p 0.001, 95% CI 0.69 – 0.91) and brain metastases (HR 0.56, p < 0.001, 95%CI 0.49 – 0.65). In multivariable analysis the survival advantage was still significant. In a sensitivity analysis, excluding patients with liver metastases, the improvement in survival persisted. Conclusions: Metastasectomy for extrahepatic disease improved overall survival in patients with colon cancer in this retrospective analysis. Further research is needed before routinely incorporating it in clinical practice.