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Purpose: The present study retrospectively analyzed thesafety and efficacy of computed tomography (CT)-guided cryoablationin the treatment ofunresectable or recurrent advanced colorectal cancer,which did not respond well to or experienced progression with radiotherapy or chemotherapy.Materials and Methods: From January 2013 to April 2015,31 lesions in 27 patients (16 males,11 females;mean age of 57.2 years) with pelvic unresectableadvanced or recurrent colorectal cancer were included in the study.The tumor diameter was approximately 3.37±1.41 cm.The primary tumor included 25 rectal cancers,1 sigmoid colon adenocarcinoma,and 1 ileocecal mucinous adenocarcinoma.Cryoablation was performed with 17-gauge cryoprobes and monitored by 64-slice spiral CT.Follow-up was carried out by contrast-enhanced magnetic resonance imaging (MRI).The treatment efficacy was evaluated by symptom palliation,decreased carcinoembryonic antigen (CEA) serum level,and tumor response.Results: The cryoablation procedure was well-tolerated in all patients without major complications or procedure-related mortali ty.Long-term complications included abscess formation (1 patient),skin frostbite and post-sacrum antrum formation (1 patient).Pain relief was satisfactory in patients with perineal pain (P＜0.001),and the median time of pain relief was 3.0 months.Complete ablations were obtained in 22 lesions of 18 patients,while 9 lesions in 9 patients underwent incomplete ablation.The median time to local recurrence for lesions with complete ablations was 15.0 months,and that to the progression of tumors with incomplete ablation was 4.0 months.Conclusion: CT-guided cryoablation is a minimally invasive,safe,and effective therapeutic option for unresectableadvanced or recurrent colorectal cancer.The treatment is well-tolerated by patients,and pain relief is achieved rapidly.