Introduction: Preoperative imaging staging of colorectal cancer is essential for optimal therapeutic planning. Multidetector computed tomography (MDCT) is the standard imaging modality for initial staging; however, its diagnostic accuracy in assessing tumor depth and nodal status remains debated.

Objective: To evaluate the diagnostic accuracy of MDCT in preoperative T and N staging of colorectal cancer by comparison with operative and histopathological findings as the reference standard.

Methods: A retrospective analysis was conducted in 63 patients with histopathologically confirmed colorectal cancer who underwent preoperative contrast-enhanced CT of the abdomen and pelvis. CT-based assessment of T and N stages was compared with operative and histopathological findings. Agreement was evaluated using appropriate statistical methods.

Results: MDCT demonstrated the highest diagnostic accuracy in identifying T3 tumors. Overall agreement between CT and histopathological findings for individual T stages was low but statistically significant (Kappa = 0.166; p = 0.049), with a predominant tendency toward understaging. When T stages were grouped into low (T1–T2) and high (T3–T4) categories, diagnostic accuracy reached 71.4%. Nodal staging with morphological status showed high agreement in binaryclassification  (Kappa = 0.682; p < 0.001), but limited reliability acording to size of lymph node

Conclusion: MDCT shows good diagnostic performance in preoperative T staging of colorectal cancer, particularly in advanced stages, while nodal staging remains limited and requires cautious interpretation.