Background Increasing numbers of colorectal cancer patients and healthcare constraints mean novel follow-up strategies need to be considered. The optimal method of follow-up is unclear; however, a patient-tailored model could reduce costs, improve patient experience and improve overall health. The aim was to explore patients’ perspective to current and alternative follow-up strategies and barriers to follow-up, to create a patient-led framework to guide further development of colorectal cancer follow-up. Methods A qualitative study was conducted using semi-structured interviews with patients who underwent curative-intent colorectal cancer surgery. Thirteen participants (seven women, five Māori, age range 41 – 86 years) were recruited in Northland. Thematic analysis was performed using the Braun and Clark method. Results Patients were mostly satisfied and experienced positivity and reassurance around follow-up visits. Patients were open to alternative methods of follow-up, with telephone and nurse-led methods being favoured options. Barriers to follow-up included inaccessibility, disability, travel and obligations. Enablers included social support and access to transport. Conclusion Colorectal cancer patients have positive experiences of follow-up with alternative modalities for follow-up being feasible. While barriers need to be addressed, some could be overcome by a patient-tailored model of follow-up.