The aim of this study was to analyze and describe the epidemiological characteristics and trends of colorectal cancer in Sassari province (Sardinia, Italy), an area with a spontaneous surveillance program for colorectal malignancies, in the period 1992–2010. Data were obtained from the local tumor registry which makes part of a wider registry web, coordinated, today, by the Italian Association for Tumor Registries. The overall number of colorectal cancer cases registered was 4.284. The male-to-female ratio was 1:0.7 and the mean age 68.3 years for males and 69.4 years for females. The standardized incidence rates were 49.3/100,000 and 31.1/100,000 and the standardized mortality rates 20.4/100,000 and 12.4/100,000 for males and females respectively. An increasing trend in the incidence of colorectal cancer in Sassari province was evidenced. Relative survival at 5 years from diagnosis was 48.6% (52.3% for males and 44.7% for females). A slight increase in mortality rates was observed, as opposed to national figures, probably attributable to the lacking of organized screening strategies in the area.