BACKGROUND: Numerous studies have reported that a majority of colorectal cancer patients in China have low levels of physical activity. Early identification of relevant factors is beneficial for formulating physical activity interventions. This study aimed to describe the status of physical activity in colorectal cancer patients and determine psychosocial predictors of low levels of physical activity. METHODS: We conducted a cross-sectional survey of 230 hospitalized patients with colorectal cancer in a tertiary hospital in Hubei Province. The research utilized a self-designed general information questionnaire, International Physical Activity Questionnaire Short Form (IPAQ-SF), Social Support Rating Scale (SSRS), Brief Illness Perception Questionnaire (BIPQ), and Posttraumatic Growth Inventory (PTGI) as assessment tools. SPSS 25.0 was used for descriptive statistical analysis, Chi-squared test, Student's t-test, and binary logistic regression analysis. RESULTS: The prevalence of low physical activity among colorectal cancer patients was 52.5%. Binary logistic regression analysis revealed that monthly per capita household income of 3000-5000 yuan (OR = 0.274, 95% CI: 0.080-0.942), monthly per capita household income >
5000 yuan (OR = 0.191, 95% CI: 0.037-0.992), duration of diagnosis between 7 and 12 months (OR = 0.132, 95% CI: 0.030-0.587), social support score (OR = 0.802, 95% CI: 0.679-0.947), illness perception score (OR = 1.136, 95% CI: 1.019-1.266), and posttraumatic growth scores (OR = 0.915, 95% CI: 0.847-0.989) were independent predictors of physical activity in colorectal cancer patients. CONCLUSIONS: Overall, colorectal cancer patients in China have low levels of physical activity. These findings may provide valuable insights for healthcare professionals to identify individuals with low levels of physical activity and to develop effective intervention strategies. In future clinical practice, healthcare providers can promote physical activity in colorectal cancer patients through interventions aimed at enhancing social interactions, improving proper knowledge and understanding of the disease, and fostering posttraumatic growth.