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The incidence of early-onset colorectal cancer (EOCRC) has been rising globally in recent years, with an especially rapid increase in disease burden in China. Compared with late-onset colorectal cancer, EOCRC is more often diagnosed following symptomatic presentation, with greater diagnostic delay and more aggressive biological behavior. Patients are typically at critical life stages regarding career development and family building, and have urgent needs for fertility and sexual function preservation, and long-term quality of life. However, current domestic and international guidelines mostly target the general colorectal cancer population, and a systematic management framework tailored to the specific characteristics of early-onset patients is lacking. Therefore, the Hereditary Cancer Committee of the China Anti-Cancer Association organized a multidisciplinary expert panel-including specialists in colorectal surgery, medical oncology, radiation oncology, pathology, genetic medicine, reproductive medicine, psycho-oncology, and specialized nursing-to develop the Chinese Expert Consensus on the Diagnosis and Whole-Course Management of Early-Onset Colorectal Cancer (2026 version), based on evidence-based medicine and Chinese clinical practice. This consensus covers clinical issues such as the definition, epidemiological characteristics, screening and diagnosis, comprehensive treatment strategies, fertility and sexual function preservation, psychosocial support, and long-term follow-up of EOCRC, and presents 18 relevant recommendations. It aims to establish a multidisciplinary team-based whole-course management model that emphasizes both tumor control and long-term quality of life, providing a reference for the standardized diagnosis and treatment of EOCRC.