Background: Though 5-FU is the mainstay of treatment for colorectal cancer, its prolonged administration is associated with infusion-related complications and patient inconvenience. Capecitabine, an oral drug, has been found to be equally or more effective in many studies. Aim: To determine the safety and efficacy of combination of Capecitabine and Oxaliplatin (CAPOX) as first line chemotherapy in South Indian patients with recurrent and previously untreated metastatic colorectal cancer. Methods and material: Thirty one patients from June 2006 to December 2008 of recurrent or previously untreated metastatic colorectal carcinoma who were treated with Capecitabine / Oxaliplatin combination regimen as first line therapy. Results: Fourteen new patients had disease response (one complete response and 13 partial responses) and eleven had progressive disease. On follow up, five of them have died of disease while one was lost to follow up. The remaining nineteen patients are alive. The median progressionfree survival was 17 weeks (range: 4 weeks - 104 weeks). Conclusions: Chemotherapy with CAPOX regimen has resulted in 45% response rate in patients with recurrent or previously untreated metastatic colorectal cancer. The regimen was well tolerated with minimal toxicity.