We report the cases of eight children and adolescents with adenocarcinoma of the colon treated at three large referral hospitals over a 25-year period. We recorded demographic factors, initial symptoms, stage at operation, type of operation, pathologic grade, and survival, and compared our results to those in the English literature. There were seven male patients and one female patient, with an average age of 15.1 years and an average duration of symptoms of 7 1/2 months. The most common initial complaint was rectal bleeding (6/8 patients, 75%). Pain, anemia, and abdominal distention were present in five of the eight patients (63%). Six of our eight patients (75%) had stage C or D disease at diagnosis, and six of the eight tumors (75%) were poorly differentiated. Only three of the eight patients lived for more than six months. Unexplained gastrointestinal bleeding or abdominal complaints in children should prompt a thorough investigation of the gastrointestinal tract.