OBJECTIVE To report a case of colorectal cancer in a 19 years old patient which was misdiagnosed as hemorrhoids.  CLINICAL PRESENTATION AND INTERVENTION  A 19 year old woman with bleeding per rectum, difficulty in passing stool for 9 months and something coming out of vagina for 2 months was admitted for examination and management. She was already taking treatment of hemorrhoids for last 9/10 months. Colonoscopy revealed malignant looking ulcerated growth which bleeds on touch suggestive of Carcinoma rectum. Histopathology suggestive of Adenomcarcinoma (brush biopsy) and mucin secreting adenocarcinoma (punch biopsy). A diagnosis of colorectal carcinoma was made on the bases of anisonucleosis with altered N:C ratio (brush biopsy), degenerated mucosal gland with malignant focus (punch biopsy). During surgery abdomino perineal resection with hysterectomy and permanent colostomy was done. Patient comes for routine checkup till 7 months and FOLFOX regime (chemotherapy) was given during these visits. The patient did not have any complications or any signs of recurrence.  CONCLUSION  This case showed that colorectal carcinoma should be considered for young female patients and should not be confused with hemorrhoids.