Background: Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the fourth leading cause of cancer death worldwide with steadily increasing mortality rates. The aim of the present study to highlight any relationship between carcinoembryonic antigen (CEA) and tumor node metastasis (TNM) stage in colorectal cancer (CRC) patients that would help in diagnosis and staging of the disease. Patients and methods: A total of 36 patients with stages IV CRC were admitted to department of General surgery, Zagazig university hospitals and underwent surgery. Full medical history, clinical examination, General and specific investigation were performed for all patients preoperatively.The CEA levels for all patients were examined preoperatively. Results: Our study showed the mean age of the studied cases ranged from 29 to 83 years with mean 54.36 years. Regarding sex 63.9% were male. Finally 38.9% were smoker. Most common sites of lesions were rectum, sigmoid colon & descending colon (44.4%, 19.4% & 13.9% respectively). The diameter of lesion among cases ranged from 1 to 15 cm with mean 5.94 cm and 38.9% had diameter from 3 to 6 cm. Regarding differentiations most frequent was moderate and mild (41.7% & 30.6% respectively). CEA level among the studied cases ranged from 0 to 23 ng/dl with mean 6.39 ng/dl and median 4.5 ng/ml. Also 58.3% had CEA level ≤ 5 ng/ml. Conclusions: There is a meaningful link between TNM stage and CEA level. However, normal levels of CEA will not rule out CRC diagnosis, and it can be concluded that these patients should be investigated in detail.