Cold snare biopsy (CSB) significantly boosts diagnostic accuracy for suspected colorectal cancer compared to cold forceps biopsy (CFB), without increasing complication rates.

• CSB achieved 100% diagnostic consistency; CFB was 90.5%.
• Clinical outcomes were similar: bleeding rates were 3.9% for CSB vs. 4.6% for CFB.

Surgeons should consider CSB as the preferred method for obtaining biopsies in suspected CRC patients to enhance diagnostic certainty.