Hematogenous metastases to the skeletal muscles are extremely rare, while the liver and lung are primary targets for distant metastasis from colorectal carcinoma. An unusual case of metastasis to the skeletal muscle of the right forearm from an adenocarcinoma of the rectum is reported herein. In addition to the rarity of an uncommon metastasis, skeletal muscle metastasis from an adenocarcinoma of the rectum as the first presentation of the metastatic disease is, therefore, extremely rare. The previously published reports are reviewed and the possible mechanisms underlying are discussed in the light of the current literature. [Turk J Cancer 2005;35(4):181-185].