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Objective: We measured CEA (carcinoembryonic antigen) levels in both serum and bile from patients with colorectal cancer (CRC) to evaluate the relationship between bile CEA levels and liver metastasis (LM). Methods: Three groups were enrolled in our study. Primary CRC group: 27 patients with CRC but without LM; LM group: 14 patients with LM from CRC; Controlled group: 20 patients with benign biliary diseases (cholelithiasis or cholecystitis). Both serum and bile were collected to measure CEA levels in all groups but only bile CEA was measured in controlled group. Results: Bile CEA level in LM group was significantly higher than that of the primary CRC group (314.27 and 13.07 ng/mL respectively; P < 0.05). In LM group bile CEA level was significantly higher than serum CEA level (314.27 and 43.51 ng/mL respectively; P < 0.05). Bile CEA level was more relevant to the number and size of LM than the primary tumor factors. Conclusion: In confirmed CRC liver metastasis, the bile CEA level is significantly elevated. Bile CEA assay may be of potential value in diagnosis of liver metastasis,especially for the occult LM.