Abstract: Regulatory T cells (Tregs) represent an important immunosuppressive cell type in the tumor microenvironment (TME), which plays a crucial role in maintaining immune homeostasis. Tregs can suppress effective anti-tumor immunity by secreting suppressive cytokines and can regulate colorectal cancer (CRC) cell growth by regulating cytokines. Tregs can also promote CRC angiogenesis directly or indirectly, contributing to poor prognosis. However, Tregs may also reduce the risk of intestinal tumorigenesis by inhibiting the inflammatory response in early stages of inflammation-related tumorigenesis. In recent years, immunotherapy targeting Tregs has become a research hotspot. Some therapeutic strategies have been applied in clinical practice, while others are in preclinical and clinical trials. The role of Tregs in CRC development and progression and the related therapeutic strategies are summarized in this review; the mechanism of action and potential clinical application of Tregs as a therapeutic target are also discussed.