Regional differences in cancer specific survival outcomes were investigated in a retrospective analysis of 29,221 cases of colorectal cancer recorded in the New Zealand National Cancer Registry over a 10-year period between 2006–2015. 42% of the study population were aged >75 years, 52% were male and 88% were New Zealand European. Survival outcomes for patients with colorectal cancer aged <75 years did not vary by regional cancer network. A higher risk of dying from colorectal cancer was evident for patients aged >75 years living in the Central Cancer Network (1.12; 95% CI 1.03–1.22) and Midland Cancer Network (1.10; 95% CI 1.02–1.18) compared with those living in the Northern Cancer Network. Disparity in outcomes was also evident for patients of Māori and Pacific ethnicity; cancer specific survival and all-cause survival were worse for Māori and Pacific patients than New Zealand European patients diagnosed with colorectal cancer.