Background <p>Early discharge after elective colorectal resection represents an extension of enhanced recovery after surgery (ERAS), yet routine adoption of same-day or &lt; 24-h discharge remains limited. Planned discharge within 48 h may offer a pragmatic balance between accelerated recovery and patient acceptance. The role of hospital-at-home (HaH) services in supporting this pathway remains uncertain.</p> Methods <p>This retrospective cohort study included adults undergoing elective minimally invasive colorectal resection between September 2023 and August 2025. Early discharge was defined as discharge within 48 h, while standard discharge followed routine ERAS pathways. Identical clinical discharge criteria were applied to both groups. A 1:1 propensity score-matched analysis compared postoperative clinical outcomes and healthcare costs. Patients meeting predefined early discharge criteria were optionally offered supplementary HaH care. Primary outcomes were postoperative morbidity, 30-day readmission, and total episode-of-care costs.</p> Results <p>A total of 102 patients underwent planned early discharge and 281 underwent standard discharge. After matching, 75 patients were analysed in each group. Early discharge was associated with a shorter postoperative length of stay (median 2 vs 5 days, <i>p</i> &lt; 0.001) and lower inpatient hospitalization costs (US$23,825 vs US$31,659, <i>p</i> &lt; 0.001). Rates of postoperative complications, 30-day readmission, mortality, and early disease recurrence were comparable. Among early discharge patients, 46 (63.9%) received HaH support for a median of 2 days. Patient and caregiver satisfaction was high.</p> Conclusions <p>Planned discharge within 48 h after minimally invasive colorectal resection appears safe, feasible, and resource-efficient within a mature ERAS program. Selective HaH support may facilitate early discharge without compromising short-term outcomes.</p> Graphical abstract <p></p>