BACKGROUND:The length of the rectosigmoid stump left after subtotal colectomy and ileostomy is believed to affect postoperative complications, including sepsis, success of future restorative proctocolectomy, and long‐term functional outcome.METHODS:We reviewed the charts of 60 patients with toxic ulcerative colitis who were treated with subtotal colectomy leaving either a short (25) or long (35) rectosigmoid stump and who eventually underwent restorative proctocolectomy between 1983 and 1992 at a large tertiary care center. Data were collected on preoperative disease duration and steroid use, operative time, blood loss, transfusion requirements, length of stay, stool frequency, fecal incontinence, and sexual dysfunction.RESULTS:There were no statistically or clinically significant differences between groups.CONCLUSIONS:Rectosigmoid stump length does not appear to affect complications or long‐term outcome in patients with toxic ulcerative colitis treated with subtotal colectomy and restorative proctocolectomy.