Purpose: It is widely known that there are large disparities in health status between Aboriginal and Torres Strait Islander (ATSI) people and the rest of the population. The aim of this study was to compare postoperative outcomes between ATSI and non-ATSI populations following colorectal cancer (CRC) surgery in a rural setting. Methodology: Patient health outcomes and demographics were determined through conducting retrospective chart reviews via the integrated Electronic Medical Records (iEMR) system. Results: 355 patients with CRC were identified as having undergone emergency or elective surgery between 2018 to 2023 at a single tertiary centre of Far North Queensland. Of these, 35/355 (9.9%) identified as ATSI compared to 320/355 (90.1%) with the mean age of each group being 58.8years and 66.8years, respectively. The difference in age of CRC diagnosis was statistically significant between both groups (p=0.01). ATSI patients were associated with a significantly higher rate of medical complications (6/37 = 17.1%) compared to their non-ATSI counterparts (42/320 = 13.1%) (p = 0.04), while there was no statistical significance observed for surgical complications (p=0.103). Moreover, length of stay (LOS) in hospital (ATSI 13.1 days versus non-ATSI 9.4 days), an ASA score of 3 or more (ATSI 76.4% versus non-ATSI 60.6%) and diabetes mellitus (ATSI 14/35 = 40% versus non-ATSI 56/320 = 17.5%) were all found to be statistically significant (p=0.03, p=0.02, p=0.004, respectively). Conclusion: This study highlights the importance of recognising ATSI patients with CRC are at greater risk of perioperative medical complications. Therefore, our study implores measures should be taken to mitigate these risks.