Neuroendocrine carcinoma (NEC) of the colon is a rare disease with few reports. Although the tumor progresses rapidly and is highly aggressive and malignant, no effective treatment has been established. In this study, we report four cases of NEC between 2010 and 2020:one male and three females aged 61 to 87 years old. The tumor location was one in the cecum, one in the ascending colon, one in the descending colon, and one in the rectum. Two cases that could not be clearly diagnosed underwent surgery. All cases had lymph node metastases. Three cases died of NEC within 3 to 6 months. Patients with colorectal NEC are often diagnosed at an advanced stage. Multidisciplinary strategies, including systemic chemotherapy, are common in the treatment of colorectal NEC. However, no effective treatment has been established. Further cases need to be accumulated to clarify the best treatment options for colorectal NEC.