The continent ileostomy, consisting of a valve and a pouch, makes available an alternative system in which intestinal discharge can be stored and controlled after coloproctectomy. Earlier concerns regarding valve slippage with resulting malfunction have been largely eliminated by recent modifications in the technique of valve construction. A continent ileostomy was provided for 19 patients. In the first five, an antiperistaltic (Kock) valve was constructed and two had dessusception which necessitated reoperation. In the 16 cases in which an isoperistaltic valve was fashioned, there has been no slippage. These improvements, along with the significant enhancement of the quality of life, indicate a need to reexamine the advisability of providing a spout-type ileostomy in those cases favorable to the construction of a continent ileostomy.