Colorectal cancer has exhibited a persistently rising incidence and mortality rate in China, emerging as a critical public health challenge. For patients with locally advanced rectal cancer, neoadjuvant radiotherapy remains the standard treatment recommended by domestic and international guidelines. Intraoperative radiation therapy (IORT), an modality integrating radiotherapy with surgical intervention, has gained prominence in recent years due to its precision in target localization, enhanced local control efficacy, and reduced risk of perioperative tissue damage. However, unresolved issues persist regarding standardized indications, technical implementation protocols, efficacy evaluation systems, and long-term outcome validation, necessitating evidence-based consensus and multicenter clinical research. To address these challenges,‌ Intraoperative Radiotherapy Working Group, Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association convened multidisciplinary experts. Synthesizing global evidence and clinical experience, the group formulated the expert consensus on intraoperative radiation therapy for colorectal cancer (2025 Edition). This consensus aims to serve as a reference for clinical practice and to advance standardized diagnostic and therapeutic protocols, fostering high-quality development in this field.