Colonoscopy-assisted natural orifice specimen extraction surgery (CA-NOSES) is a minimally invasive surgical approach in which the resected specimen is completely extracted through the colonic lumen and anus with the assistance of colonoscopy, following laparoscopic or robotic radical resection of colon tumors and intracorporeal digestive tract reconstruction. It represents an important extension of the existing natural orifice specimen extraction surgery (NOSES) system. To standardize the clinical application of this technique, Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association, the NOSES Committee of the Chinese Anti-Cancer Association, and the China NOSES Alliance organized experts from relevant fields nationwide. Based on a systematic review of the domestic and international literature and in conjunction with accumulated clinical experience in China, consensus was achieved through extensive discussion, leading to the formulation of this expert consensus. This document systematically addresses key aspects of CA-NOSES, including its definition and technical characteristics, indications and contraindications, preoperative evaluation and bowel preparation, equipment selection and patient positioning, standardized operative procedures, prevention and management of complications, as well as oncological outcomes. Current evidence indicates that, when indications are strictly adhered to and aseptic and oncological principles are rigorously followed, CA-NOSES offers advantages such as reduced surgical trauma, faster postoperative recovery, and improved cosmetic outcomes. Its safety and oncological efficacy are not inferior to those of conventional laparoscopic-assisted colectomy with mini-laparotomy for specimen extraction in colon tumor surgery. This consensus aims to provide practical technical guidance and a theoretical basis for the standardized implementation of CA-NOSES and to lay a foundation for future multicenter clinical studies.