Abstract: Lymph node involvement is one of the most important prognostic factors for colorectal cancer. Para-aortic lymph node metastasis (PALNM) is an uncommon mode of metastasis of colorectal cancer. Because the incidence of colorectal cancer is lower than that of liver and lung metastases, related studies have certain limitations. Therefore, the diagnosis and treatment of PALNM in colorectal cancer are unclear. Para-aortic lymph node dissection (PALND) can provide a pathological diagnosis and can also improve the prognosis of some selected patients. Although aggressive surgical resection of colorectal cancer with liver and lung metastases is indicated, the optimal surgical management strategy for colorectal cancer with PALNM remains unclear. To determine whether PALND should be performed, the relationship between its safety, effectiveness, recurrence rate, and survival benefit needs to be assessed. This study reviews the research and treatment progress of PALNM in colorectal cancer in recent years.