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Objective We aimed to verify the efficacy of integrated Chinese and Western medicine in the treatment of patients with metastatic colorectal cancer ( mCRC). Methods 733 mCRC patients who visited Xiyuan Hospital of Chinese Academy of Chinese Medical Sciences, Beijing Cancer Hospital and Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine between August 1, 2013 and December 31, 2015 were enrolled. A cohort study design was adopted, and “ receiving continuous traditional Chinese medicine (TCM) for ≥3 months” was taken as the exposure factor. Patients who met this criterion were classified into the integrated Chinese and Western medicine cohort, and patients who did not meet this criterion were classified into the Western medicine cohort. Overall survival (OS) and the 1 -, 3 - and 5 - year survival rates were compared between the two cohorts. A multivariate risk proportional regression model was used to explore the factors affecting the prognosis of mCRC patients. Results A total of 335 patients with mCRC were included in this study, including 129 patients in Chinese and Western medicine cohort and 206 patients in Western medicine cohort. The median overall survival (mOS) in the Chinese and Western medicine cohort was 28. 0 months and that of the Western medicine cohort was 20. 3 months. The difference was statistically significant (HR = 0. 748, 95% CI = 0. 587-0. 950, P<0. 05). The 1-, 3- and 5-year survival rates of the Chinese and Western medicine cohort were 96. 0% (120 / 125), 36. 8% (46 / 125) and 10. 4% (13 / 125), respectively. The 1-, 3-, and 5-year survival rates of the Western medicine cohort were 79. 9% (159 / 199), 23. 1% (46 / 199) and 6. 0% ( 12 / 199), respectively. The 1 -, 3-year survival rates of Chinese and Western medicine cohort was higher than Western medicine cohort(P<0. 01). Subgroup analysis showed that there was a significant difference in mOS between the two cohorts in the female, right-side colon, RAS mutation, no targeted therapy, and non-chemotherapy subgroups (P<0. 05, P<0. 01). Multivariate analysis showed that right-side colon, non-chemotherapy, RAS mutation, and low differentiation were independent prognostic factors for poor prognosis of mCRC and integrated of Chinese and Western medicine was a protective factor (HR = 0. 529, 95%CI = 0. 386-0. 714, P<0. 01), which reduced the risk of death by 47. 1%. Conclusion Integrated of Chinese and Western medicine can prolong the OS of mCRC patients, and the benefits are more obvious in women and in patients with right-side colon cancer and RAS mutation. Integrated of Chinese and Western medicine can significantly reduce the risk of death in mCRC patients. At the beginning of Western medicine treatment, the early integrated of traditional Chinese medicine will bring greater survival benefits to mCRC patients. [ABSTRACT FROM AUTHOR]