Objective: To investigate the expression of survivin in the peripheral blood of the patients with colon cancer and its relations with recurrence and metastasis of colon cancer. Methods: The expression of survivin mRNA in peripheral blood of patients with colon cancer was detected by combined use of reverse transcriptase polymerase chain reaction and enzyme-linked immunosorbent assay (RT-PCR-ELISA), and the relations between its expression and the clinicopathological features were analyzed. Fifty-one patients were followed up for 36 months to analyze the relevance of the time to metastasis and relapse with the expression of survivin mRNA. Results: The expression rate of survivin mRNA in the peripheral blood of the 95 patients with colon cancer was 36.8% (35 cases). The expression rate of survivin mRNA for well to moderately differentiated cancer and poorly differentiated to undifferentiated cancer was 31.0% and 45.0%, respectively. The expression rate of the patients with tumor penetrating the serosa was 44.0%, which was higher than that of the patients with only the involvement of submucosa and muscularis (20.0%) (P＜0.05). The expression rate of the patients with lymph node metastases was 47.5%, which was higher than that of the patients without lymph node metastasis (19.4%) (P＜0.05). The follow-up study showed that the incidence of metastasis and relapse of the patients with survivin positive expression (47.3%) was higher than that of the patients with survivin negative expression (16.6%). The results demonstrated that expression of surviving mRNA in the peripheral blood was associated with the degree of tumor differentiation, depth of infiltration, lymph node metastasis and clinical stages, but was irrelevant to the tumor site. Conclusions: The patients with surviving positive expression in the peripheral blood are prone to metastasis and relapse. The expression of survivin in the peripheral blood may be an indicator for evaluating the biological behaviors and prognosis of colon cancer.