Despite significant advances in the management of colorectal cancer the identification of new prognostic biomarkers continues to be a challenge. Since its initial discovery, the role of the Hedgehog (Hh) signaling pathway in carcinogenesis has been extensively studied. We herein review and comment on the prognostic significance of the Hedgehog signaling pathway in colorectal cancer (CRC). The differential expression of Hh pathway components between malignant and non-malignant conditions as well as correlation of Hh activation markers with various clinicopathologic parameters and the impact on disease-free survival (DFS), overall survival (OS) and disease recurrence of patients with CRC is summarized and discussed. According to the studies reviewed herein the activation of the Hh pathway seems to be correlated with adverse clinicopathologic features and worse survival. However, to date study results show significant variability with regards to the effect on outcomes. Such results need to be interpreted carefully and emphasise the need for further well-designed studies to characterise the actual influence of the Hedgehog pathway in CRC prognosis