OBJECTIVE To establish an evaluation index system for the selection of therapeutic drugs for colorectal carcinoma， providing a basis for clinical medication decision-making. METHODS A preliminary framework for the evaluation index system for the selection of therapeutic drugs for colorectal carcinoma was constructed through literature research and expert surveys. Using the Delphi method， consultations were conducted with 40 experts engaged in the use and evaluation of antitumor drugs， ultimately forming the evaluation system for selecting therapeutic drugs for colorectal carcinoma. RESULTS The effective recovery rate of questionnaires for both rounds of inquiries was 100%， with the reliability coefficients of 0.82 and 0.85. The Kendall’s W coordination coefficients were 0.251 and 0.252 （the P values of χ 2 tests were both less than 0.05）. The final evaluation system constructed included 6 first-level indicators （safety， efficacy， cost-effectiveness， suitability， innovation， and accessibility） and 29 second-level indicators （such as disease control rate， precise treatment of target diseases， objective remission rate， and whether clinical medication complies with authoritative recommendations）. Among these， efficacy and accessibility received high average importance scores （4.60， 4.30 points）， with “disease control rate” and “precision treatment for target disease” carrying relatively high weights （both were 0.035 2）. CONCLUSIONS This study successfully established a drug evaluation index system for the selection of therapeutic drugs for colorectal cancer that aligns with clinical practice.