Colorectal cancer mostly develops from precancerous lesions. Thus, timely recognition of these lesions is of considerable interest for prevention. Globally, the most widely used non-invasive colorectal cancer screening approach is quantitative faecal immunochemical testing (FIT) for occult blood, however its performance in detection of precancerous lesion is still imperfect. So far, limited number of volatile organic compounds (VOCs) analysis studies have addressed detection of high-risk colorectal precancerous lesions, namely—high-risk adenomas. This chapter reviews the available evidence on VOC application for the detection of colorectal precancerous lesions. Breath, faecal and urine samples have been used for this purpose by different investigators. Although the initial data are promising, and VOC testing has been reported to outperform traditional FIT, additional evidence is needed before VOCs could be applied for the detection of colorectal precancerous lesions in clinical practice. Furthermore, large studies in screening settings are necessary before the concept could be recommended in cancer screening.