From inflammatory diseases to oncologic conditions, gastrointestinal and colorectal surgery addresses a wide range of disorders with increasing emphasis on function-preserving, patient-tailored interventions. Laparoscopic and robotic platforms are now standard in resections for colorectal cancer, diverticulitis, and inflammatory bowel disease, offering faster recovery and lower complication rates. Transanal total mesorectal excision (taTME) and natural orifice specimen extraction (NOSE) exemplify the drive toward less invasive techniques without compromising oncologic integrity. Enhanced preoperative staging, selective use of neoadjuvant therapy, and intraoperative fluorescence imaging aid in surgical planning and precision. Function-preserving strategies, including intersphincteric resection and colonic J-pouch formation, aim to improve postoperative quality of life. The field continues to evolve with a focus on individualized care, reducing recurrence, and supporting long-term gastrointestinal function.