BACKGROUND The purpose of this study was to determine if pretreatment serum albumin and cholesterol levels are prognostic factors in patients with colorectal carcinomas. METHODS Ninety-nine patients with colorectal carcinoma were included in this study. Retrospective data analysis included the clinicopathological parameters of age and gender; emergent surgical intervention; stage at presentation; tumor location, size, and differentiation; lymph node metastases; lymphatic, venous and perineural invasion; preoperative serum albumin, cholesterol, hemoglobin, and CEA levels; the presence of preoperative and postoperative metastases; and tumor recurrence. RESULTS Low levels of serum albumin, advanced TNM stage, presence of venous invasion, and high CEA levels were independently correlated with prognosis in multivariate analysis. Advanced stage and low levels of serum cholesterol were found to be a statistically significant parameter for disease free survival. Mean serum albumin levels were found to be decreased in patients with advanced stage, which correlated with increased tumor burden. Although not statistically significant for cholesterol levels, the patients with low serum albumin and low cholesterol levels had shorter overall survival than patients with normal serum albumin and normal cholesterol levels. CONCLUSIONS These results suggest that a preoperative low level of serum albumin can be an indicator for the malignant potential of the tumor and represents an unfavorable prognosis for patients with colorectal carcinoma.