errated polyposis syndrome (SPS) is a condition characterized by the presence of multiple and/or large serrated polyps in the colon, representing a significant risk factor for colorectal cancer (CRC). Recent updates in the clinical criteria for SPS have refined the definition to include specific criteria related to the number and size of serrated polyps. Individuals with SPS have an increased risk of CRC, emphasizing the importance of early detection and intervention. The serrated pathway of carcinogenesis, involving the accumulation of serrated polyps, plays a crucial role in the development of CRC. RNF43, a gene implicated in the Wnt pathway regulation, has been linked to the serrated pathway and may contribute to the development of SPS and serrated polyps. Understanding the genetic variants of RNF43 in relation to SPS could provide valuable insights into the pathogenesis of this syndrome. The indications and age for recommended surgery in patients with SPS remain unclear, but it is suggested that individuals under 40 years old with more than 100 polyps should consider prophylactic surgery. This decision underscores the importance of individualized treatment strategies based on the patient's risk profile and polyp burden. This abstract highlights the significance of recognizing the serrated pathway in CRC development and the importance of early screening and detection of SPS to mitigate the risk of CRC. Further research on genetic factors, such as RNF43 variants, is essential for a comprehensive understanding of SPS and its implications for colorectal cancer prevention and management.