Purpose <p>Colorectal cancer (CRC) accounts for a tenth of all cancers and cancer-related deaths diagnosed annually worldwide, with incidence and mortality rates significantly lower in women compared to men. High-intensity interval training exercise (HIIT) is a type of physical activity that has shown benefits in other cancer populations. The objective of this systematic review and meta-analysis is to determine the benefits in health outcomes, and the viability of this type of training on CRC patients and survivors who have undergone a HIIT intervention.</p> Methods <p>A search was conducted in the Pubmed, Cochrane, Scopus and SPORTDiscus databases. Randomized clinical trials were selected. ROB 2.0 was used to analyze the risk of bias. The variables included were cardiorespiratory capacity, body composition, fatigue, symptoms of neuropathy induced and functional capacity.</p> Results <p>Ten articles that met the inclusion criteria were included, resulting in a total of 1182 identified articles. One selected article had a low risk of bias. It is not clear that HIIT is better than moderate-intensity or standard care in terms of cardiorespiratory capacity. Body composition changed positively in the HIIT group, reducing fat mass and increasing fat-free mass over the moderate-intensity group. Fatigue was reduced more with HIIT, although not significantly. The meta-analysis did not show significant results due to the small sample of included studies.</p> Conclusions <p>HIIT could be beneficial to improve several outcomes. However, heterogeneity in the interventions has been found, which prevents us from clearly stating that HIIT is the best exercise treatment option in these patients.</p> Trial registration <p>PROSPERO registration: CRD42021255004.</p>