Objective  To explore the expression of survivin mRNA in peripheral blood of patients with colorectal cancer and its clinical significance. Methods  SPSS16.0 software was used for statistical analysis. χ2 test was used. Collected 90 patients with colorectal cancer and 60 patients with colorectal adenoma disease in general surgery of baoding first central hospital. 60 healthy people were selected as control group during the same period. The expression of Survivin in serum of patients with colorectal cancer, patients with colorectal adenoma disease and healthy controls before operation was detected and compared by nested RT-PCR. To analyze the correlation between the level of Survivin mRNA in serum of patients with colorectal cancer and clinicopathological features such as stage, pathological type, degree of differentiation and distant metastasis after operation. Results  Survivin was not expressed in healthy people. Survivin was expressed in 2 patients with benign colorectal adenoma (3.33%) and 49 patients with colorectal cancer (54.44%) in peripheral blood. The expression rate of survivin was closely related to tumor stage and distant metastasis (P<0.05). Significant correlation (P>0.05). Conclusions  The expression of survivin in peripheral blood of patients with colorectal cancer is significantly up-regulated, which is closely related to the stage and distant metastasis of colorectal cancer. It can be used as a good molecular marker to detect metastasis in peripheral blood of patients with colorectal cancer and to evaluate the progress of cancer.