Objective To investigate the characteristics and risk factors associated with regional lymph node metastasis in colorectal neuroendocrine neoplasm. Methods The clinical and pathological data of 79 patients with colorectal neuroendocrine neoplasm were retrospectively analyzed. The risk factors of regional lymph node metastasis were evaluated by multifactor Logistic regression analysis. Results The incidence of regional lymph node metastasis was 30.4% (24/79), among which para-intestinal lymph node metastasis was in 14 cases, mesenteric lymph node metastasis in 6 cases, and mesenteric root central lymph node metastasis in 4 cases. No patient was found to have skip metastasis and mesenteric root distant lymph node metastasis. The single factor analysis results showed that the tumor diameter, ulceration in mucous membrane, depth of invasion, pathological grading and invasion of lymphatic vessel were associated with regional lymph node metastasis in patients with colorectal neuroendocrine neoplasm (P<0.05). The multifactor Logistic regression analysis results showed that the tumor diameter, pathological grading and invasion of lymphatic vessel were was associated with regional lymph node metastasis in patients with colorectal neuroendocrine neoplasm (P<0.05). Conclusions The colorectal neuroendocrine neoplasm patients with larger tumor diameter, G2 and G3 of pathological grading and invasion of lymphatic vessel have higher incidence of regional lymph node metastasis; the mesenteric lymph node and para-intestinal lymph node should be paid special attention to in radical resection.