This single-institutional, retrospective series comes from a high-volume center with a large experience in reconstructive surgery after failed colorectal anastomosis. This is a poorly investigated topic although these difficult cases are relatively frequent in tertiary referral centers. The authors point out the substantial morbidity associated with such reoperative pelvic cases and emphasize the importance of patient selection. They also formulate a score system associated with reconstruction success which can be practically used when evaluating these patients.