Cancer diagnosed during pregnancy has increased because of delayed child‐bearing and the known occurrence of age‐dependent malignancies. Cases of colorectal cancer (CRC) in pregnancy have recently been reported. With the expected rise in CRC diagnosed in young adults coupled with the current trend of delayed child‐bearing, CRC during pregnancy is likely to increase. Treating pregnant women with CRC by using antineoplastics presents a dilemma because there are many unknowns to guide treatment decisions. We review the issues regarding the use of 10 CRC‐approved agents in pregnancy. Implications for Practice: Colorectal cancer (CRC) in pregnancy is likely to become more common because of the current population trend in delayed child‐bearing and the increase in CRC incidence expected among young adults. Practitioners should become familiar with the challenges associated with systemic treatment of a pregnant patient with CRC. This review addresses concerns surrounding the 10 systemic agents approved for CRC to help provide treatment guidance when such a case arises. 摘要 在妊娠期间诊断为癌症的病例越来越多, 这是由于生育年龄推迟以及已知年龄依赖的恶性肿瘤的发生。近期有研究报告了妊娠期结直肠癌 (CRC) 病例。鉴于预期CRC诊断在较年轻的成年人中出现升高, 加之当前生育推迟的趋势, 妊娠期间CRC很可能会增加。对患有CRC的妊娠女性使用抗肿瘤治疗是一个两难问题, 因为在治疗决策指导中存在太多未知因素。我们对10种获批可用于妊娠期治疗的抗CRC药物的相关问题进行了回顾。The Oncologist 2016;21:563–570 对临床实践的提示: 由于目前人群的生育年龄有推迟趋势, 并且预期较年轻成年人中的结直肠癌 (CRC) 发生率会增加, 因此妊娠期间 CRC 很可能变得更为常见。临床医生应熟悉这一问题及妊娠期 CRC 患者系统治疗的相关挑战。本综述介绍了 10 种获批的 CRC 系统性治疗药物的相关问题, 可能有助于此类病例出现时的治疗指导。 Although infrequent, cases of colorectal cancer (CRC) during pregnancy have been reported in the last decade. With the trend in delayed child‐bearing, CRC during pregnancy will likely rise in incidence. This review focuses on CRC antineoplastics and the challenges that are present when their use is considered during pregnancy.