The early results of colectomy and ileorectal anastomosis (IRA) in 57 patients with ulcerative colitis seemed fair. The operative mortality was relatively low (7%) also in fulminating cases (10.5%), which constituted one-third of the material. The late results were less satisfactory. Half the survivors were in need of rectal extirpation and ileostomy because of rectal dysfunction. Until now 6% have developed cancer of the rectal stump. The early diagnosis of this condition was difficult. The results regarding rectal function, stenosis, and inflammation were significantly worse in women than in men. Moreover, dyspareunia was a severe problem in more than half the women. We have abandoned IRA in the treatment of ulcerative colitis.