NAT2 gene polymorphisms can influence colorectal cancer (CRC) risk. We aimed to determine the extent to which NAT2 gene polymorphisms influence the survival of patients with sporadic colorectal cancer.Seventy patients with sporadic colorectal cancer that underwent surgery at the 3rd Surgical Department of Cluj-Napoca between October 2003-May 2005 were randomly selected. Correlations between NAT2*5C(T341C), NAT2*5A(C481T), NAT2*6B(G590A), NAT2*7B(G857A) polymorphisms and survival of patients with different Dukes-MAC stages of CRC were analyzed. We compared patients with a slow acetylator genotype with those having an intermediate or rapid acetylator genotype.The slow acetylator 341CC genotype is a negative prognostic factor, 20% vs. 30.8%, as compared to rapid acetylator 341TT/TC genotypes (p=0.02) in the patients diagnosed with stage C CRC. For the same stage patients, the slow acetylator 481CC was a positive prognostic factor, 33% vs. 25% (p=0.03). The slow acetylator 590AA was a negative prognostic factor for the survival of patients with stages B and C, 0% vs. 31% (p=0.02). The slow acetylator 857AA genotype was a negative prognostic factor for the patients in stage B, survival rate 0.69% vs. 50%, and positive for patients with stage C, survival rate 50% vs. 21% (p=0.0101). The rapid acetylator 341TT/TC represented a good prognostic factor, while the slow 341CC a negative one for stage D patients (p= 0.04, survival of 18.9%) HR=0.30 with 95%, CI[0.025- 0.9810].The NAT2 gene may be considered as a prognostic factor for the survival of patients with CRC.