The cAMP/PKA signalling events regulated by A-kinase anchoring proteins 10 (AKAP10) is involved in tumorigenesis. Previous study showed that AKAP10 polymorphism (2073 A/G, I646V) was associated with colorectal cancer risk. However, there was no literature reporting the role of AKAP10 in the pathogenesis of colorectal cancer. The aim of the study was to investigate the clinicopathologic significance of A-kinase anchoring proteins 10 (AKAP 10) expression and the relationship with its polymorphism in colorectal cancer. The expression of AKAP10 was determined by immunohistochemical staining (IHC) and western blot assay on colorectal cancer (n=176), adenoma (n=87) and distant normal mucosa (n=72). 176 patients with colorectal cancer were genotyped for AKAP10 2073A/G polymorphism by TaqMan RT-PCR. We found that the positive expression rate of AKAP10 in colorectal cancer (59%) was significantly higher than those in adenoma (39%) and distant normal mucosa (42%) (P=0.004). There was no significant difference between adenoma and distant normal mucosa (P=0.741). Positive AKAP10 staining was correlated with deeper tumor invasion (P<0.001)), lymph nodes metastasis (P=0.022), advanced tumor stage (P<0.001) and poorly differentiated degree (P=0.003). Compared with AA genotype (52%), positive expression of AKAP10 was significantly increased in colorectal cancer patients with the variant (AG+GG) genotypes (68%, P=0.033). It was concluded that AKAP10 may play an important role in the development and progression of colorectal cancer.