Objective To explore the influencing factors for compliance to colonoscopy screening for colorectal cancer in outpatients. Methods Patients aged 40‑74 years who visited the outpatient gastroenterology department of 7 tertiary hospitals in 7 regions of Xinjiang from January 2022 to June 2022 were enrolled. Recommendations for colonoscopy screening were made according to the patient''s medical conditions, and the questionnaire was used to collect information. The Chi‑square test was used to compare the differences of compliant and non‑compliant patients. Multivariate logistic regression was used to analyze the influencing factors of compliance to colonoscopy screening. Results A total of 463 valid questionnaires were obtained from 7 centers, in which, 427 outpatients (92.2%) followed the recommendation for colonoscopy screening, and 36 (7.8%) did not. Chi‑square test results showed that there were statistically significant differences between the two groups in gender, age, education, subjective cognition of intestinal polyps, personal history of colorectal polyps, family history of colorectal cancer, family history of colorectal polyps, abdominal pain or distension, and defecation habit or stool changes (P<0.05). The results of multivariate regression analysis showed that the screening compliance of patients aged 40‑49 years (P=0.005, OR=0.141, 95%CI: 0.036‑0.549) and 50‑59 years (P=0.039, OR=0.257, 95%CI: 0.071‑0.932) was lower than that of patients aged 60‑74 years. The screening compliance of patients with high school education (P=0.011, OR=3.121, 95%CI: 1.304‑7.473) and college education or above (P=0.016, OR=3.544, 95%CI: 1.270‑9.890) was higher than those with primary school education and below. Patients with personal history of colorectal polyps (P=0.015, OR=12.288, 95%CI: 1.629‑92.719), family history of colorectal cancer (P=0.038, OR=8.506, 95%CI: 1.124‑64.351) and changes in defecation habit or stool trait (P=0.039, OR=4.794, 95%CI: 1.085‑21.192) also had higher compliance. Conclusion Age, educational level, personal history of colorectal polyps, and family history of colorectal cancer are related to colonoscopy screening compliance in outpatients of 7 tertiary hospitals in 7 regions of Xinjiang. The independent risk factors affecting compliance to colorectal cancer screening in outpatients are age of 40‑59 years, lower educational level, no previous history of polyps or family history of colorectal cancer, and no defecation habit or stool changes.