The use of chemotherapy in patients with colorectal carcinoma has changed considerably in recent years. New drugs, drug combinations, and innovative methods of administration are now available for the palliative treatment of patients with metastatic disease. Based on the results of recent clinical trials, adjuvant chemotherapy appears to prolong survival for certain patients who have undergone surgical resection of colorectal cancer. This review article includes a summary of pertinent medical literature and ongoing clinical trials, and provides treatment recommendations.