Purpose Early-onset colorectal cancer (EOCRC) patients have advanced disease and undergo more aggressive surgeries and multiple lines of chemotherapy. Minimal studies have evaluated how this affects the health-related quality of life (HRQoL) of EOCRC patients. This study investigated the HRQoL of Australian EOCRC patients including a subset who underwent pelvic exenteration (PE) or cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Methodology Patients were included if they underwent a colorectal resection at the Royal Prince Alfred Hospital, Sydney Australia. This was a cross-sectional study and patients were divided into groups based on the time interval from their index operation: ≤2 years and >2 years. Norm-based scores obtained from the SF-36v2 questionnaire were used to evaluate HRQoL. Results 50 patients were included in this study. The median physical component summary (PCS) and mental health component summary (MCS) scores were 53.3 (36.4-58.9) and 47.3 (37.5-55.7) in patients ≤2 years from surgery. The median PCS and MCS scores were 50.6 (43.3-57.7) and 50.2 (39.04-56.2) in patients >2 years from surgery. Stage I vs II disease (31.9 vs 58.9, p=0.04) and emergency vs elective surgery (36.1 vs 56.3, p=0.007) conferred poorer PCS scores in patients ≤2 years from surgery. No other variables impacted PCS or MCS scores in EOCRC patients in either group. Conclusion The HRQoL of EOCRC patients was similar to the Australian population. Physical functioning in patients ≤2 years from surgery was impaired by having earlier stage disease and emergency index surgery. Future large-scale prospective studies including an assessment of the functional outcomes of EOCRC patients is warranted.