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To investgate the correlation between expression of BH3-only proteins (PUMA and BIM) and clinical outcome of colorectal cancer (CRC) patients administrated with oxaliplatin-based chemotherapy.Experimental Design: We retrospectively analyzed clinicopathological features and PUMA and BIM expressions by immunohistochemical staining (EnVision)in 121 stage Ⅱ-Ⅳ CRC patients undergoing resection and treated with oxaliplatin-based chemotherapy to identify predictors of postoperative recurrence and survival rates.Meanwhile, we selected two strains of human colon cancer cell lines SW480 and HT29, respectively adding oxaliplatin, detected cell growth and inhibition by application of MTT ,detected apoptosis by flow cytometry, detected Bim and PUMA expression by fluorescence quantitative PCR.Results PUMA in colorectal cancer tissues were positive expressed (82.4%),which was significantly lower than in the normal mucosa colorectal adenomas (93.3%) and normal mucosa tissues (96.7%).PUMA expression is related to tumor differentiation, invasion depth, vascular violations, lymph node metastasis, TNM stage and P-gp expression (p <0.05), but not related to the patients age, gender, tumor size tumor histological type and GST-Ⅱexpression (p> 0.05).1,3,5 year survival rate of the positive expression of PUMA in patients undergoing resection and treated with oxaliplatin-based chemotherapy is significantly higher than that of PUMA in patients with negative expression.Positive expression rate of BIM in colorectal cancer tissues (62.7%) is significantly lower than that in normal mucosa (96.7%) and colorectal adenomas (90.0%)(p<0.05).BIM expression is related to tumor differentiation, invasion depth, lymph node metastasis, TNM stage and P-gp expression (p <0.05), but not related to patients age, sex, tumor size ,tumor histological type, invasion depth and GST-Ⅱ expression(p> 0.05).1,3,5years survival rate of BIM positive expression patients undergoing resection and treated with oxaliplatin-based chemotherapy is significantly higher than that in patients with negative expression (p <0.05).PUMA and BIM in colorectal cancer tissues were positively correlated (p <0.05).COX multivariate analysis shows that PUMA and BIM can be used as independent prognostic indicators for patients receiving oxaliplatin-based chemotherapy (p<0.05).After the treatment of oxaliplatin in the human colon carcinoma cell, SW480 line growth was obvious inhibited (P < 0.05), the apoptosis rate were significantly higher than those in control group (P<0.05); Bim and PUMA expression in SW480 strain increased significantly.While the same processing in HT29 cell lines, there was no obvious inhibition of growth, while its Bim and PUMA expression had no obvious change.Conelusions The proapoptotic BH3-only proteins Bim and Puma can provide prognostic information for colorectal cancer patients receiving oxaliplatin-based adjuvant chemotherapy.PUMA and BIM maybe play an important role in oxaliplatin-induced apoptosis of human colon carcinoma.