Background: Effects of disease symptoms and treatment negatively impact the HRQoL of patients (pts) with mCRC, including physical and psychological well-being. Understanding challenges faced by pts with mCRC may help improve HRQoL and enhance their disease journey. Using an online survey, we aimed to gain insights into the effects of mCRC on HRQoL. Methods: Pts aged ≥18 yrs with stage IV colon, rectal, or colorectal cancer participated in an online survey conducted in the US by The Harris Poll between 01/17/24-02/07/24. Of the 344 pts who participated, 254 were recruited via online panels and 90 via pt advocacy groups (PAGs; BLKHLTH, COLONTOWN, Colorectal Cancer Alliance, and Family Reach). The 60-question survey explored the pt profile, diagnosis experience, the role of PAGs/other resources, HRQoL, access to care and financial challenges, discrimination, and treatment experience. Raw data were not weighted and thus are only representative of participants who completed the survey. Sample data are accurate to within 5.3 %-points using a 95% confidence level; all surveys are subject to multiple sources of error. Results: Of 344 participants, 190 (55%) were male, mean age was 56 yrs (±13 yrs); the majority were White (n=158 46%), Black/African American (n=87 25%), or Hispanic (n=75 22%). Of applicable respondents, a majority reported that mCRC had a negative impact on maintaining a normal work schedule (69%), financial wellbeing (69%), emotional wellbeing (67%), hobbies (64%), physical activity (63%), and romantic relationships (61%). However, 43% of applicable pts reported a positive impact on relationships with family and friends, while 70% of overall respondents agreed that a diagnosis had inspired them to act on things they’ve always wanted to do or have pushed off. From an emotional perspective, most pts agreed that they felt like a burden to family (72%) or sensed decreasing support over time from family/friends (63%). Although for many pts a diagnosis had brought them closer to loved ones, 78% agreed they had at times felt alone in their experience, and 70% struggled with being emotionally present. Further, among 330 (96%) pts who had attempted to access mental health resources, 55% had found this difficult, especially Black pts compared to Hispanic and White pts (Table). Conclusions: During their disease journey, pts with mCRC suffer a deterioration in multiple aspects of HRQoL that affects their daily lives, including emotional/mental wellbeing. Better support, specifically improving ease of access to mental health resources, is needed to help pts maintain HRQoL throughout their disease journey.