Background <p>Colorectal cancer commonly metastasizes to the liver and lungs; however, cervical and vaginal involvement is exceedingly rare. This report describes in detail a unique case of cervical and vaginal metastasis of ascending colon cancer.</p> Case presentation <p>A patient presented with vaginal bleeding. Investigations revealed discontinuous malignant lesions in the cervix and vagina. Following a series of examinations, the patient underwent radical cervical and vaginal resection. Pathology confirmed adenocarcinoma, and combined with immunohistochemical results, the cervical and vaginal lesions were determined to be metastatic from a previous ascending colon cancer.</p> Conclusions <p>Clinicians should consider the rare possibility of cervical or vaginal metastasis in colorectal cancer patients presenting with symptoms like vaginal bleeding during follow-up. If investigations confirm oligometastatic cervical and vaginal lesions from colorectal cancer, radical cervicovaginal resection to achieve no evidence of disease, with postoperative systemic treatment, may be indicated for long-term survival. Given the often limited prognosis and potential for systemic disease in such cases, the multidisciplinary decision-making process and systemic therapy or palliative care, are crucial for managing future cases.</p>