Summary and ConclusionsA report of the records of 20 patients with chronic ulcerative colitis in which ileorectal anastomosis was performed during the past 24 years has been presented. There were two deaths. Problems associated with this type of surgery are presented.In the final analysis, the decision to perform an ileorectal anastomosis will depend upon the patients' desires and the attitude of the physician. Should an ileorectal anastomosis fail and complicated disease persist, it is still possible to perform a rectal excision and permanent ileostomy.