The objectives of this retrospective, observational study are to compare the compliance and tolerance rate between elderly and non-elderly patients with colorectal cancer, and to ascertain the stage at presentation. All adult patients with diagnosis colorectal cancer who received first line chemotherapy (adjuvant or palliative) between January 2017-January 2019 were included. Data on demographic, clinic-pathological, treatment and patient outcome were collected. Toxicity data was collected as they appear. These data were then analyzed using IBM®SPSS® Statistics Version 24. Sixty-four patients were included. There were almost equal numbers of elderly and non-elderly patients. Thirty-five patients were Malay (54.7%), Chinese 26 (40.6%) and Indian 3 (4.7%). Their age ranges from 38-82 years old. Most patients received FOLFOX regimen (73.4%), followed by Mayo regimen and capecitabine (10.9% each). There was no significance difference in the type of chemotherapy and number of cycles given. The majority received combination therapy rather than single therapy. There was no difference in the terms of toxicity between the study populations. Thirty-three percent of elderly and thirty-five percent of non-elderly patients had no documented chemo-toxicity. The most common toxicity is neutropenia, followed by thrombocytopenia and anaemia. In total, 25% (16 patients) did not complete their chemotherapy for various reasons. Nine were elderly patients (56.3%). Presentation at Stage 3 and 4 accounted for 70.3% (45 patients) of the study population. Elderly colorectal cancer patients’ should be treated with equal therapeutic opportunities as their younger counterparts. Biological age should be considered when deciding treatment regime rather than chronological age.