Objective: To investigate the clinical diagnostic value of CT virtual colonoscopy (CTVC) in preoperative determination of the nature and localization of colorectal cancer. Methods: The imaging and clinical data of 51 patients with colorectal cancer undergoing preoperative CTVC and colonoscopic examination as well as surgical treatment were retrospectively analyzed. Results: The whole group of 51 patients were confirmed to have colorectal cancer by surgical biopsy and pathological examination. After surgical confirmation, the detection rate of CTVC and colonoscopy was 100% and 92.0%, respectively. Localization accuracy of CTVC was 100%, while that of colonoscopy was 93.6%. The coincidence rate of clinical staging by preoperative CTVC was 94.1%. Conclusions: CTVC is a non-invasive method that can determine the extent of extra-intestinal invasion and metastasis, inspect the proximal bowel wall in cases with severe luminal stricture and comprehensively define the nature and position of the tumor. Furthermore, it is complementary to colonoscopy, and is of great importance in clinical staging of colorectal cancer and selection of the operative procedure.