We aim to evaluate in this systematic review the impact of combined clinical and surgical strategies on survival and quality of life in patients with advanced colorectal cancer and hepatic metastases (CRLM). We designed and followed our search on PubMed, Cochrane Library, Embase, and Google Scholar for studies published between 2010 and 2024. Inclusion criteria encompassed studies reporting survival rates and quality of life outcomes in patients who went through clinical or surgical management for CRLM and our data extraction and quality assessment were performed using standardized tools and risk of bias of included RCTs was accessed using Cochrane risk of bias tool. We found liver-first approach demonstrated improved 3-year overall survival (69%) for synchronous CRLM compared to combined or classic approaches with 54.4–60.4%. Neoadjuvant chemotherapy facilitated tumor downstaging but was associated with liver injury when prolonged beyond five cycles and those patients with metachronous CRLM, surgical resection come with maximum survival rate with five-year survival rates reaching 60% in selected cases and quality of life outcomes was improved in patients achieving curative resection. After all research, it can be can conclude that combined clinical and surgical strategies and tailored sequencing of treatment can enhance survival and quality of life for CRLM patients. Early multidisciplinary interventions and optimized chemotherapy regimens are critical in balancing oncologic outcomes and treatment-related risks.