&NA;Restorative proctocolectomy and ileal reservoir, performed as a two‐stage procedure, has the advantages of a shorter hospital stay, one less anesthetic, and a shorter time with a stoma when compared with the three‐stage procedure. In a prospective, nonrandomized study of 152 consecutive patients undergoing restorative proctocolectomy (57 two‐stage and 95 three‐stage), the complication rates for the ileal reservoir phase and the functional results of the two‐ and three‐stage operations were compared. The results suggest that there is no advantage to the three‐stage procedure except in the following circumstances: when urgent surgery is required for the complications of ulcerative colitis, when malignancy or Crohn's disease cannot be ruled out, and when a patient with active colitis has a combination of a low hemoglobin value (male<13.5 g/dl, female<11.5 g/dl), a low serum albumin level (<40 g/l), and is taking oral steroids.