Sacral chemotherapy for 5 years metastasis of colon cancer is the most important, local radiotherapy can be done for sacral metastasis after involvement, and some of them can also do targeted therapy. Bone metastasis of colon cancer can occur in cervical spine, thoracic spine, lumbar spine, ribs or pelvis, etc., and the treatments are different for different bone metastasis sites. For patients with bone metastasis of colon cancer, in addition to regular chemotherapy and other means of active treatment of colon cancer, local radiotherapy can be done for sacral metastasis to prolong patients’ life and improve their quality of life. Chemotherapy drugs include capecitabine alone or combined with oxaliplatin. In addition, targeting drugs such as cetuximab or bevacizumab can be considered on the basis of chemotherapy. In conclusion, the main treatment plan for sacral metastasis in advanced colon cancer is chemotherapy, and radiotherapy can be added on the basis of chemotherapy to deal with the pain, and at the same time cooperate with targeted therapy.