The aim of this retrospective study was to assess the morbidity of twisted loop ileostomy (TLI). Between 1985 and 1994, 83 TLI were performed in 79 patients. Before TLI closure, 13 patients (16%) presented complications, requiring surgery in 5 cases. Small bowel obstruction (7 cases: 8%) and high stoma output (4 cases: 5%) were the commonest complications. After stoma closure (performed in 76 cases), 8 patients (10.5%) presented complications, requiring surgery in 3 cases. The most commonest complication was enteric fistula (4 cases: 5.3%) requiring reoperation in 2 cases. This procedure adds a separate set of postoperative complications, which tend to be minor in nature without any permanent sequelae and which can be minimized by a meticulous surgical technique. This technique remains a safe and effective procedure for fecal diversion.