African Americans in the United States are more likely than their white counterparts to experience greater incidence and mortality due to colorectal cancer (CRC). Present for decades, these disparities have prompted researchers to investigate underlying causes and potential explanations. While some biological variations have been observed between races, evidence shows that approximately 50% of these disparities can be attributed to differences and disparities in CRC screening, resulting in reduced polyp removal for CRC prevention and/or early detection of CRC among African Americans. Other major contributors to CRC disparities are differences in treatment and access to care. Significant efforts are needed to increase CRC screening among African Americans through targeted interventions to reduce barriers such as increasing education, promoting physician recommendations, and providing affordable and quality care. Intervention is also needed to educate the medical community about these issues and to change health policy to provide a multilevel approach with the best chance of success in reducing racial disparities in CRC.