Colorectal cancer (CRC) is a serious health problem around the world. It is the third most common cancer and the second leading cause of cancer-related deaths. The primary treatment for non-metastatic CRC is surgery and/or chemoradiotherapy along with surgery, while standard treatments for unresectable CRC include the combination of chemotherapy, biological agents (monoclonal antibodies), targeted therapy, and immunotherapy. However, standard care cannot satisfactorily reduce recurrence and mortality rates. Therefore, more effective strategies need to be developed for managing treatment-resistant tumors. Many researchers have evaluated neoadjuvant chemotherapy for CRC with limited metastasis and operable disease for optimal curative resection by downstaging or decreasing the volume of the tumor and reducing the risk of metastasis. Important updates, guiding our practice and providing novel information, were shared at the 2024 American Society of Medical Oncology's Gastrointestinal Cancers Symposium (ASCO GI). Along with the increase in identified current targets and treatments for metastatic disease, the utility and validation of circulating tumor DNA assays, especially for early-stage/limited metastatic operable CRC, and organ-sparing approaches in patients with rectal cancer who respond to total neoadjuvant treatments were examined in detail. In this review, we summarized the developments specifically for CRC.