Early-onset colorectal cancer (EO-CRC), defined as colorectal adenocarcinoma diagnosed before age 50, is increasing globally, with distinct clinicopathologic and molecular features compared to adult-onset disease. While risk factors such as genetic mutations and lifestyle influences are implicated, pediatric cases remain exceptionally rare. This report presents a unique case of colorectal adenocarcinoma with multiple metastases in an 11-year-old patient, contributing critical insights into the molecular pathogenesis and diagnostic challenges of EO-CRC in pediatric populations. Furthermore, the aggressive nature of this disease underscores significant treatment challenges, ranging from limited evidence-based therapeutic protocols for young patients to variable responses to multimodal therapies, resulting in a generally poor prognosis.