Background: Globally, colorectal cancer is a substantial health burden. This case will discuss about challenges during management due to pregnancy. To the best of authors’ knowledge, very few cases of this type have been reported in the literature. Case Presentation: A 20-year-old married, pregnant female, second gravid and para 1 presented during her 34th week of gestation, with complaints of something coming out of the anus, bleeding per rectum, abdominal distension, and relative constipation for 8 months. Carcinoembryonic antigen was normal. CT scan and MRI showed circumferential mural thickening of length 7.5 cm involving anal canal and anorectal junction, associated with perilesional fat stranding. The neoadjuvant chemoradiotherapy was advised after c section. Conclusion: This case report highlights the fact that early detection and management of colorectal cancer during pregnancy can prevent morbidity and mortality.

Keywords: Colorectal cancer, Pregnancy, case report