Although treatment options for ulcerative colitis (UC) are expanding, some patients still require surgical intervention with the removal of the diseased colon and rectum. Proctocolectomy with ileal pouch-anal anastomosis, also known as pouch surgery, is the surgery of choice for the majority of these patients. Pouchitis, an inflammation of the pouch, is the most common long-term complication in patients undergoing pouch surgery. This chapter will review the indications and the surgical technique of pouch surgery, the medical management of patients with pouch, the clinical manifestations of postoperative complications, and the role of the IBD nurse in the medical team caring for patients with pouch.