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Early-onset colorectal cancer (EOCRC) is on the rise at an alarming rate, with incidence set to double by 2030. Unlike CRC in the elderly, its development appears to be influenced by lifestyle and environmental factors, in addition to genetic predisposition. As the majority of cases are sporadic, modifiable factors such as obesity, a sedentary lifestyle, alcohol and tobacco play a major role. Biologically, PD-RCC has distinct tumor characteristics, associated with late diagnosis, more aggressive progression, and consequently an often unfavorable prognosis. Although younger patients tolerate intensive treatment better, the efficacy of current strategies remains uncertain. In view of this trend, lowering the age of screening, better molecular characterization and raising awareness among healthcare professionals are essential to optimize early detection and improve the prognosis of CRC.