Purpose Early onset colorectal cancer (EoCRC) is frequently diagnosed at a more advanced stage than in older patients. The incidence of EoCRC in Australia is increasing, potentially resulting in more emergency presentations due to the complications of advanced cancer in the young. The objective of this study was to analyse the rates of open surgery, stoma formation, deep wound dehiscence and anastomotic leakage for patients with EoCRC requiring emergency surgery, compared to elective operations. Methodology All adult patients under 50 years of age with colorectal cancer identified from the BioGrid Australia database between 2003 – 2023 were included for analysis. Relative risk (RR) of the outcomes of interest was calculated with a 95% confidence interval (CI). Results Of 748 operations, 136 were emergent (18%). Proportion of emergency surgery differed by tumour site: right colon (30/180, 17%), left colon (101/327, 31%) and rectal cancer (5/241, 2%). Patients undergoing emergency surgery for colon cancer were 40% more likely to be Stage III & IV than electives. Emergency operations were significantly more likely to be performed open (right colon: RR 2.0 (CI 1.5-2.7, p<0.0001), left colon: RR 2.4 (CI 2.0-3.0, p<0.0001), rectum: RR 2.2 (CI 1.9-2.6, p<0.0001)). Stoma formation occurred more often in the emergent setting (right colon: RR 4.2 (CI 1.4 – 12.9, p=0.01), left colon: RR 4.5 (CI 3.0-6.6, p<0.0001), rectum: RR 1.3 (CI 1.2-1.4, p<0.0001)). Deep wound dehiscence and anastomotic leak rates were low with no significant differences between groups. Conclusion Surgery was performed emergently for 18% of EoCRC cases. These patients were more likely to have an advanced stage and require open surgery and stoma formation. Further research into achieving earlier diagnosis may reduce the surgical morbidity in this patient group.