Up to one fourth of patients diagnosed with colorectal cancer present with liver metastases, and by the time of death, up to 70 percent of patients with colorectal cancer have metastatic disease to the liver. At present, surgical excision is the standard therapy for resectable liver metastases from colorectal primaries. This article reviews the natural history of colorectal metastases to the liver and results of studies of systemic chemotherapy, surgical resection, and alternative surgical approaches.