This study was conducted to determine the clinical usefulness of radioimmunoguided surgery (RIGS) using human-mouse chimeric Fab monoclonal antibody A7 (ch-Fab-A7) for colorectal cancer patients. Ten colorectal cancer patients were given iodine-131-labeled ch-Fab-A7 intravenously (i.v.) 2 to 7 days prior to RIGS. The RIGS was carried out using a portable gamma detecting probe (GDP). Tumor localization was identified by GDP intraoperatively in 4 of the ten patients, while liver metastasis and lymph node metastasis were identified in 2 patients and 1 patient, respectively. The GDP revealed tumor/surrounding tissue radio(gamma)count ratios of 1.5 or greater in 8 of the ten resected tumors. Although RIGS using ch-Fab-A7 is a promising tool for intraoperatively identifying the tumor localization of colorectal cancer, 125I, rather than 131I, should be used as a tracer for RIGS to enhance the accuracy of ch-Fab-A7.