OBJECTIVES: Anti-angiogenic therapy has become an integral component of treatment for metastatic colorectal cancer patients. During last 10 years several studies were conducted to test the safety and efficacy of anti-angiogenic therapies in mCRC patients. This study reviewed the results of randomized controlled trials published in peer-reviewed journals. METHODS: We searched the MEDLINE, and abstracts from ECCO, ESMO and ASCO until May 2011. Studies were selected for randomized controlled trials on targeted anti-angiogenic drugs in mCRC. Primary endpoints reviewed were progression-free (PFS) and overall survival (OS). Response rates, toxicity and secondary resectability were secondary endpoints. Aggregated data were further analyzed to understand comparative safety and efficacy. RESULTS: Until May 2011, eligible mCRC randomized clinical trials for this review  were available for bevacizumab (5 trials including 3101 patients) and vatalanib (2 trial including 2033 patients). Overall, anti-angiogensis therapy for mCRC shows significant OS and PFS benefit versus comparators. The median OS and PFS benefit for regimens containing Bevacizumab were 3 and 3.15 months, versus background chemotherapy. The median OS and PFS benefit for vatalanib containing regimens were statistically insignificant versus background chemotherapy.  CONCLUSIONS: Anti-angiogensis therapy with Bevacizumab for mCRC shows significant OS and PFS benefit versus comparators.