The presence of regional lymph node metastases in colorectal cancer is one of the most important prognostic factors. However, the extent of lymph node dissection in colorectal cancer surgery is still controversial. The presence of extraregional lymph node metastasis only is not a common metastatic pattern for colorectal cancer. This type of cancer is usually combined with distant metastasis or extensive regional lymph node metastasis and is categorized as M1 disease. Management of extraregional lymph node metastasis in colorectal cancer has been challenging due to lack of supportive data. Here, we summarize the approaches and managements of this category of diseases, focusing on the role of surgical treatment in colorectal cancer.