Laparoscopic colorectal cancer surgery results in a reduced impact on the immune system compared with open surgery. This is important when taken into consideration that the immune system may have an instrumental role in the advancement of cancer in the perioperative period. Several studies have shown that the perioperative period is characterized by an immune incompetent period, which is believed to favour tumour metastasis. In this paper factors associated with the cellular and innate immune response in relation to laparoscopic and open colorectal cancer surgery are reviewed.