In order to assess the efficacy of 18F-FDG PET/CT-based diagnostic model in diagnosing colorectal cancer (CRC) lymph node metastasis (LNM), the 18F-FDG PET/CT medical records of CRC patients were acquired, and the CRC regional LNM diagnostic model was constructed through the combination of image and grain factors of 18F-FDG PET/CT. The specific analysis methods include univariate analysis, multivariate analysis, ROC curve analysis, and statistical analysis. The research results showed statistical differences in TNM staging, intestinal obstructions, tumor infiltration, regional lymph node (LN) SUVmax, regional LN minimum dimension, and remote metastasis between the CRC patients in the LNM positive group and the LNM negative group. Through the comparisons between the diagnostic model proposed in the research and other diagnostic methods, it was found that the AUC (95%CI) and sensitivity of the proposed diagnostic model were the highest, the comprehensive diagnostic efficacy of the diagnostic model was optimal. Therefore, it was concluded that the diagnostic model was of significant application values, which provided the basis for subsequent clinical diagnosis of CRC. © 2019 The Author(s).