Colorectal cancer (CRC) is one of the most common malignant neoplasms in Egypt. Adenomatous polyps and inflammatory bowel diseases (IBD) are considered the commonest pre-malignant lesions for CRC. Adipocytokines (Adiponectin, Resistin and Visfatin) are promising markers that may play a role in early detection of CRC. Aim of work: to assess levels of Adiponectin, Resistin and Visfatin in pre-malignant and malignant colorectal lesions. Patients and methods: 114 patients were studied and divided into 4groups; CRC group (34 patients), IBD group (24 patients), colonic polyps group (27 patients) and control group (29 patients) (patients with different indications for colonoscopy and showed negative full colonoscopic examination) by measuring levels of Adiponectin, Resistin and Visfatin in each patient of each group using ELISA technique. Results: Adiponectin is increased in CRC group rather than other 3 studied groups and its level decreased in IBD than polyp, Visfatin is significantly higher in control group than the other 2 groups (benign and CRC) and it increased in IBD than Polyp with inverse relation with stage of CRC. Resistin level has no significance in CRC group but it increased in IBD than polyp groups and it has direct relation with CRC staging. Conclusion: Adiponectin and Visfatin are good biomarker in early detection of CRC while Resistin is good biomarker in premalignant lesion and progression of CRC.