Rectal cancer combined with adrenal metastasis without advanced stage has usually lost the chance of radical surgical resection, suggesting comprehensive treatment such as sex chemotherapy, targeted therapy and immunotherapy. Rectal cancer is a malignant tumor originated from rectum, which is one of the common malignant tumors in digestive system with poor prognosis. The incidence of adrenal metastasis is 1.9% to 17.4%, adrenal metastasis is often accompanied by synchronous multiple metastasis of other organs, clinically isolated adrenal metastasis of rectal cancer is rare. Colorectal combined adrenal metastasis is already in advanced stage, and the treatment is mainly based on chemotherapy and radiotherapy. 1. if the primary foci and adrenal metastases can be removed, both of them can be surgically resected; if the primary foci can be removed but the metastases can not be removed, palliative resection can be performed on the primary foci, and the metastatic foci can be given interventional therapy and other local radiotherapy; if the primary foci can not be removed, “short-circuit” surgery or stoma surgery is feasible. 2. adjuvant treatment or systemic treatment can be used to treat the adrenal metastasis of colorectal cancer, which is in the advanced stage. 2. Adjuvant therapy or systemic therapy, single or combined therapy such as chemotherapy, radiotherapy, targeted therapy, immunotherapy, etc. should be chosen according to the situation. In conclusion, colorectal combined adrenal metastasis is advanced and requires comprehensive treatment. It is recommended to go to the regular hospital for comprehensive assessment of the condition, choose the appropriate treatment plan according to the situation, and follow the doctor’s instructions to actively cooperate with the treatment, so as to avoid delaying the condition.