To describe how colorectal practice guidelines (PGs) incorporate the patient perspective.We searched in the GIN library, MEDLINE, National Guideline Clearinghouse, NHS evidence database and Trip-database. Two authors independently selected the PGs.. We considered recommendations rated or worded as weak or conditional, or suggesting multiple options, as potentially preference sensitive. Two authors independently evaluated if, in potentially sensitive recommendations, the patient perspective was incorporated.We included twenty-eight PGs that contained 588 recommendations, being 256 potentially preference-sensitive. Ten PGs (36%) included patients in the development process, and twelve (43%) provided information about patients' perspectives. Nine PGs (32%) included recommendations in which the patient perspective was explicitly considered, and 13 (46.4%) that recommended a discussion with the patient. From a total of 588 recommendations, 9.7% (25/256) of potentially preference-sensitive recommendations considered the patient perspective. The inclusion of patients in the development process was associated with a more frequent incorporation of the patient perspective in potentially preference sensitive recommendations (70% vs 0%, p<0.001).Guideline users should be aware that the incorporation of the patient perspective in colorectal cancer PGs is suboptimal. Guideline developers should make efforts to incorporate the patient perspective, especially in preference-sensitive recommendations.