Background: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels to evaluate the efficacy of colorectal cancer liver metastasis (CRCLM) treatment is still rare. Purpose: To investigate the predictive value of DCE-MRI combined with serum CEA and CA 19-9 concerning the efficacy of comprehensive treatment for CRCLM. Materials and Methods: A total of 120 patients with CRC were retrospectively recruited using convenience sampling between May 2019 and March 2024. After treatment, they were divided into two groups according to the treatment efficacy: responders (86 cases) and non-responders (34 cases), and their clinical data were collected for comparison. Results: Before treatment, there were statistically significant differences between the groups in terms of the proportion of positive CEA (chi(2) = 17.364, p < 0.001), the proportion of positive CA 19-9 (chi(2) = 23.639, p < 0.001), the rate constant of a contrast agent from the vascular to the interstitial compartment (K-trans) (chi(2) = 2.341, p = 0.023), and the rate constant between the extravascular extracellular space (EES) (K-ep) (chi(2) = 2.556, p = 0.011). The values of K-trans, K-ep, CEA, and CA 19-9 reflected a certain degree of predictive value for the efficacy of comprehensive treatment in patients with CRCLM (p < 0.05). The combination of the four measurements is better than any single value, with an area under the curve of 0.898 (95% CI: 0.833, 0.922). Conclusion: Dynamic contrast-enhanced magnetic resonance imaging, CEA, and CA 19-9 have predictive value for the early efficacy of comprehensive treatment for CRCLM.