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Background: This study aimed to explore the survival and recurrences of stage I colorectal cancer (CRC) patients. Through the analysis of the results of preoperative serological values, we seek to find factors associated with the survival and recurrence of patients with stage I CRC. Methods: We retrospectively enrolled patients from 2012 January to 2015 April. Survival rates were calculated with the Kaplan–Meier method and survival curves were compared using the log-rank test. The independent prognostic factors were assessed by the Cox proportional hazard regression analysis. Results: A total of 476 patients with stage I disease were included to analysis. Median follow-up was 68 months (4–84 months) for OS. The OS rates were related to age,CEA, CHOL, LDL-C levels,HBDH, WBC, NLR, LMR, LWR, PNI, SII, NPS and CONUT at univariate analysis. At multivariate analysis, age, WBC and SII were confirmed to be independent prognostic factors for OS. The median DFS was 68 months (2–84 months). In this period, 38 (8.0%) experienced tumor relapse, and 17 (44.7%) died due to recurrence. The DFS rates were related to higher CEA, higher NLR values and lower LMR values at univariate analysis. At multivariate analysis, just elevated CEA levels was confirmed to be independent prognostic factors. Conclusions: Patients with stage I colorectal cancers still have a clinically significant risk of recurrence. We still need to expand the number of cases to validate our findings and better identify patients who are at high risk of relapse with less severe disease.