Abstract: Objective To observe the outcomes and prognosis of patients undergoing simultaneous laparoscopic resection of colorectal cancer and synchronous liver metastasis. Methods A retrospective cohort study was performed in 41 patients with colorectal cancer and synchronous liver metastasis admitted to our department from January 1, 2011 to August 1, 2013. Of the 41 cases, 18 underwent simultaneous resection of colorectal cancer and liver metastasis by laparoscopic approach and 23 by open approach. There were no significant differences in general characteristics between two groups. All available clinical and pathologic data, perioperative esults and survival outcomes were collected and compared. Results Estimated blood loss (198.33±180.66) ml vs (686.96±665.76) ml, P=0.004), intraoperative blood transfusion cases (11 vs 3, P=0.037) in open group were significantly higher than hose of the laparoscopic group, and postoperative length of hospital stay in open group was longer than that of laparoscopic group (12.00±5.77) d vs (16.61±8.12) d, P=0.048). No significant difference was observed in postoperative complications, operating time and three-year overall survival rate between the two groups. Conclusion For colorectal cancer patients simultaneous aparoscopic resection for colorectal cancer and synchronous liver metastasis is safe and effective, and achieves similar prognosis as open approach with less blood loss and shorter length of hospital stay.