Rising trends in the incidence and mortality of early-onset CRC in those who are ages less than 50 years have been well-established. These trends have spurred intense investigation focused on elucidating the epidemiology and characteristics of early-onset CRC, as well on identifying strategies for early detection and prevention. In this review, we provide a contemporary update on early-onset CRC with a particular focus on epidemiology, molecular characterization, red flag signs and symptoms, and screening for early-onset CRC.