Restorative proctocolectomy is considered the procedure of choice in the surgical treatment of ulcerative colitis and familial adenomatous polyposis coli. It is considered a therapeutically option that can cure both diseases avoiding permanent ileostomy and having good functional results. The operative procedure consists of total rectocolectomy excepting the anus, preserving the sphincter but with rectal mucosectomy. Digestive continuity is established by an ileal pouch and ileal pouch-anal anastomosis. Despite the high morbidity rate, functional results after restorative proctocolectomy seems to be better after one year after closure of the diverting ileostomy.