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Background and aim In Mexico, cancer is the second leading cause of death after cardiovascular diseases, and colorectal cancer (CRC) represents 4% of all deaths due to cancer. More than 80% of patients with CRC are treated in tertiary cancer centers with advanced tumors (stages III and IV). However, there is no colonoscopy-based screening program. Our primary objective was to determine the prevalence of colorectal neoplasm. Materials and methods A prospective, cross-sectional study was conducted, by using a consecutive series of subjects who underwent their first colonoscopy screening. Patients between 40 and 79 years of age and in good general health and in whom colorectal cancer was not suspected were included. Results A total of 600 personal letters were sent. Of these, 123 subjects responded to the invitation, of which 14 were excluded. A total of 99 patients completed the study, 73 (74%) were women and 26 (26%) were men, with a mean (±SD) age of 50.1 ± 7.41, with a mean BMI of 27.20 ± 3.74 kg/m2. Overall, 35 (35%) patients had 47 colorectal neoplasm. Among these, there were 25 adenoma (9 were advanced adenoma) in 17 (17%) patients. The location of the lesions was: caecum 6.3%, ascending colon 8.5%, transverse 19.1%, descending 19.1%, sigmoid 21.2%, and rectum 25.5%. There was a trend to have more adenoma in men (RR = 2, 95%CI: 0.83–4.62, p = .139). In conclusion, the prevalence of adenomas detected by screening colonoscopy screening in the Mexican population is not different from that published in world literature.