Introduction: The aims of the South Australian Clinical Registry for Metastatic Colorectal Cancer are to record case outcomes according to site of recurrence and mode of clinical practice and to utilize the accumulated information for quality assurance activities. Methods: All patients who had a diagnosis of synchronous or metachronous metastatic colorectal cancer (CRC) after 1 February 2006 were eligible to be included in the registry. Data on patient details, disease characteristics, investigations, histopathology and treatment were collected. Disease-specific survival data were assessed using Kaplan-Meier product moment estimates and the log-rank test of equality was used for comparisons. Results: 1544 patients have been entered as of 22 March 2010. In addition, 54.7% of primary CRCs were in the rectosigmoid area, 92.9% of them adenocarcinomas. Also, 52.6% of patients received chemotherapy and 15% had radiotherapy. Two hundred five patients underwent liver resection, nine had radiofrequency ablation and seven had selective internal radiotherapy. The overall 3-year survival from time of diagnosis of metastatic CRC was 29.5%. There was no significant survival difference between patients with synchronous and metachronous metastatic CRC. Patients with lung- or liver-only metastases have significantly improved survival if they underwent surgical resection. Discussion: The treatment of patients with metastatic CRC continues to progress with modern medical and surgical developments. Important insights into the current patterns of care and clinical outcomes for metastatic CRC are provided by these data. In addition, this registry provides a feasible and useful database for the evaluation of current treatments established as best evidence in this population.