Background and Aims Lymph node dissection and digestive tract reconstruction are important issues to be solved in colorectal cancer surgery, and indocyanine green (ICG) imaging technology has been widely used in clinical practice with good results in recent years. The purpose of this study was to investigate the application value of ICG and near-infrared fluorescent imaging (ICG-NIR) in laparoscopic colorectal cancer surgery.Methods The clinical data of 234 patients undergoing laparoscopic radical resection of colorectal cancer from July 2019 to December 2020 in the Department of Gastrointestinal Surgery of the Third Xiangya Hospital, Central South University were analyzed retrospectively. Of the patients, ICG-NIR imaging technology was used in 37 cases during operation (ICG group), and 137 cases underwent the conventional laparoscopic procedure without using ICG-NIR imaging technology (non-ICG group). The general data, surgical variables, and intraoperative and postoperative complications were compared between the two groups of patients.Results There was no significant difference in baseline data between the two groups (all P>0.05). There were no significant differences between ICG group versus the non-ICG group in terms of the average intraoperative blood loss (87 mL vs. 98 mL), average operative time (195 min vs. 220 min), and surgical procedures between the two groups (all P>0.05). In the ICG group, 2 cases underwent re-anastomosis after changing the surgical margins during operation because the ICG fluorescent imaging showed poor blood flow in the anastomosis, while no surgical plan change was made in the non-ICG group. The unplanned operation rate between the two groups had a statistical difference (P=0.024). There were no significant differences between the ICG group versus the non-ICG group in the median time to the first postoperative gas passage (3 d vs. 3 d), the median length of hospitalization (10 d vs. 10 d), the incidence rate of anastomotic leakage (2.7% vs. 5.5%), the overall incidence of complications (5.4% vs. 8.1%) and the mean comprehensive complication index (20.03 vs. 18.16) (all P>0.05). The mean number of lymph nodes detected in the ICG group was higher than that of the non-ICG group (17.37 vs. 14.29, P=0.002), but there were no statistically significant differences in the mean number of positive lymph nodes (1.40 vs. 1.45) and proportion of cases with lymph node metastasis (32.4% vs. 39.5%) between the two groups (both P>0.05).Conclusion The application of the ICG fluorescence technique in laparoscopic radical resection for colorectal cancer is safe and feasible. It can guide lymph node dissection to improve operation quality and assist in real-time evaluation of intestinal perfusion. However, it shows no advantages in reducing the incidence of anastomotic leakage and overall complications.