This review deals with several topics of interest, including ileal pouch-anal anastomosis, pouch salvage surgery, stricture-plasty, and the use of laparoscopy in the management of inflammatory bowel disease. The management of small bowel obstruction is discussed. New insights are offered on the causation of Roux stasis syndrome. Factors influencing the healing of small bowel anastomoses are reviewed. Adaptive changes that occur with the short bowel syndrome are described. Finally, the current experience with small bowel transplantation is highlighted.