Purpose: Colorectal adenocarcinoma will rarely metastasise to the spleen or ovaries in the absence of widely disseminated disease. Growing evidence suggests that “oligometastatic” or limited metastatic disease can be treated surgically with good oncological outcomes. Splenic and ovarian metastases are not well represented in studies of oligometastatic colorectal cancer, resulting in uncertainty in the best management for these patients. Methodology: We use the case of a 78-year-old woman diagnosed with metachronous colorectal metastases to spleen and bilateral ovaries to frame a literature review of surgical treatment of oligometastatic disease. The databases PubMed, Scopus, Embase and Medline were used in this review. Results: Liver and lung metastases are most commonly seen in oligometastatic colorectal cancer, with evidence that surgical resection improves 5-year survival. However, these resections are associated with high rates of major complications. No other cases in the literature described oligometastatic disease to the spleen and ovaries. Limited case series and case reports describe splenic and ovarian metastases either isolated or associated with disease in liver, lung or peritoneum, where surgical resection is used based on surgeon discretion. Conclusion: Limited evidence is available to assess the use of surgical resection in treating oligometastatic colorectal adenocarcinoma, especially when involving atypical sites. Evidence from liver and lung resection suggest that aggressive surgical management may improve oncological outcomes.