Surgical therapy remains the primary curative treatment for colorectal cancer, whereby a distinction must be made between colon and rectal cancer. En bloc resection of the tumour, including the associated lymphatic drainage, is essential to ensure oncological radicality. Conventional, laparoscopic and robotic surgical procedures achieve comparable oncological results, with minimally invasive techniques offering advantages in terms of blood loss, postoperative recovery and complication rates. Anatomically, colon cancer is resected by complete mesocolic excision (CME) with central vascular dissection, while partial or total mesorectal excision (PME/TME) is standard for rectal cancer. Although TME has led to a significant reduction in local recurrences, it requires a high level of surgical expertise to preserve autonomic nerves and optimise functional outcomes. Robot-assisted procedures offer particular advantages in rectal surgery, contributing to lower complication rates and shorter hospitalisation times with equivalent—or even slightly improved—oncological outcomes compared to laparoscopic procedures. In cases of locally advanced tumours or recurrence, multivisceral resection is often possible and requires interdisciplinary cooperation.