In recent years, with the continuous improvement of people’s living standard, changes in dietary habits and diet structure as well as the aging of population, the incidence and mortality rate of colorectal cancer in China have been on the rise, and most patients are already in the middle and late stages when they are found. In general, liver metastasis, lung metastasis and abdominal metastasis are common in colorectal cancer, while bone metastasis is relatively rare. The first bone metastasis of intestinal cancer is not common in clinical practice. Early stage is usually asymptomatic, but bone isotope scan can detect the lesioned bone. The symptoms of bone metastasis of intestinal cancer are related to the location and quantity of tumor metastasis, such as chest pain caused by rib metastasis, which is mostly manifested as pain confined to the chest wall area with clear pressure points. Spinal metastasis causes pain in the middle of the back or the lesion site, while bone metastasis in the extremities or trunk causes limited pain in that area. Initially, the bone pain is not obvious and not easily detected by patients, but as the disease gradually deteriorates, the bone pain will worsen, which will affect the daily movement and life of patients. Advanced bone metastases are mostly osteolytic lesions, so pathological fractures and paralysis sometimes occur. When bone metastases appear in bowel cancer, most patients are already in advanced stage, which not only leads to physical pain and increases patients’ suffering, but also the treatment difficulty at this time can be imagined, and the cure has almost become an impossible task. It often takes more than 1 year from the production of bone metastasis to the appearance of clinical pain. Therefore, bowel cancer patients should not refuse clinical examination and exclude the symptoms of bone metastasis of bowel cancer because of no pain symptoms. Cancer bone pain is characterized by fixed location, gradually increasing pain and more obvious at night. Early detection of bowel cancer bone metastasis symptoms can help improve the cure rate of bowel cancer bone metastasis. Although the bone metastasis of bowel cancer is more serious, as long as the patient has confidence and can actively cooperate with the doctor, there is a chance for treatment, and the survival can be prolonged as much as possible. In order to prevent the emergence of bone metastasis from bowel cancer, patients should have timely treatment in the early stage and pay special attention to whether there is a tendency of metastasis, so as to eliminate the impact of metastasis on patients’ later stage as early as possible. There are many imaging means (CT, PET-CT, isotope, etc.), and fine needle aspiration of suspicious lesions is the main means for clear diagnosis. The treatment of bone metastasis of intestinal cancer is the key, with detailed preoperative evaluation and multidisciplinary discussion. For resectable patients, one-stage surgery can be considered along with postoperative adjuvant therapy, and regular postoperative review is needed to effectively control recurrence and metastasis. For unresectable patients, adjuvant therapy can be considered before evaluation. The emergence of bisphosphonates and targeted drugs has brought new hope to patients and clinicians. Combined with radiotherapy and chemotherapy, they can reduce the toxic side effects of radiotherapy and chemotherapy and improve the efficacy of radiotherapy and chemotherapy. For patients with advanced cancer pain, radiotherapy and palliative chemotherapy are also an effective method to relieve pain.