Abstract Objective: Distant organ metastasis remains the primary factor affecting long-term survival following radical surgery for colorectal cancer (CRC). This study aimed to develop and validate an interpretable machine learning (ML) model to predict the 5-year cumulative risk of distant metastasis after radical CRC surgery. Methods: A retrospective observational cohort study was conducted using clinical and follow-up data from 341 CRC patients who underwent radical surgery.